Healthcare Provider Details

I. General information

NPI: 1114917135
Provider Name (Legal Business Name): RUSSELL LEE BARFIELD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 05/02/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9300 DE WITT LOOP
FT BELVOIR VA
22060
US

IV. Provider business mailing address

6002 OXPEN CT APT P1
ALEXANDRIA VA
22315-4768
US

V. Phone/Fax

Practice location:
  • Phone: 808-351-1151
  • Fax:
Mailing address:
  • Phone: 808-351-1151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number12458
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: