Russell Lee Carlisle, DO

NPI #1689263717 in Wesson, Mississippi

Provider Information

NPI Number: 1689263717
Entity Type: Individual
Name: Russell Lee Carlisle, DO
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Family Medicine
Credential: DO
Enumeration Date: Jan 13, 2021
Last Updated: Jan 13, 2021

Practice Location

Address: 10058 SYLVARENA RD
City: Wesson
State: Mississippi
ZIP Code: 39191-9055
Phone: (601) 757-5791

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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