Ricky Russell, M.d. LLC

NPI #1912049487 in Jackson, Mississippi

Provider Information

NPI Number: 1912049487
Entity Type: Organization
Organization Name: Ricky Russell, M.d. LLC
Primary Specialty: Ophthalmology
Enumeration Date: Feb 13, 2007
Last Updated: Jan 29, 2014

Practice Location

Address: 501 MARSHALL ST
Address 2: SUITE 603
City: Jackson
State: Mississippi
ZIP Code: 39202-1651
Phone: (601) 985-9120

Authorized Official

Name: DR. RICKY GORDON RUSSELL, M.D.
Title: PHYSICIAN
Phone: (601) 985-9120

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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