Healthcare Provider Details

I. General information

NPI: 1417252537
Provider Name (Legal Business Name): RUSSELL HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2011
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3316 HIGHWAY 280
ALEXANDER CITY AL
35010-3369
US

IV. Provider business mailing address

PO BOX 939
ALEXANDER CITY AL
35011-0939
US

V. Phone/Fax

Practice location:
  • Phone: 256-329-7109
  • Fax: 256-329-7617
Mailing address:
  • Phone: 256-329-7109
  • Fax: 256-329-7617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. LOTHER E PEACE III
Title or Position: PRESIDENT/CEO
Credential:
Phone: 256-329-7188