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General NPI Number Information
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NPI Number | 1356452361
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Entity Type | Individual
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Provider Name | HOWARD W RUSSELL M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 8120 MAIN ST STE. 302
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City | HOUMA
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State | LA
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Zip | 70360-3403
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Country | US
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Telephone | 985-223-0682
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Fax | 985-223-0686
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Provider Business Mailing Address
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Address Line | 8120 MAIN ST STE. 302
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City | HOUMA
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State | LA
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Zip | 70360-3403
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Country | US
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Telephone | 985-223-0682
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Fax | 985-223-0686
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | MD12455R
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License Number State | LA
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