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General NPI Number Information
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NPI Number | 1639327075
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Entity Type | Individual
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Provider Name | JANET YOUNG RUSSELL M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/27/2008
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 4939 W RAY RD SUITE 28
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City | CHANDLER
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State | AZ
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Zip | 85226-2065
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Country | US
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Telephone | 480-785-8800
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Fax |
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Provider Business Mailing Address
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Address Line | 12014 E WELSH TRL
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City | SCOTTSDALE
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State | AZ
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Zip | 85259-5108
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Country | US
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Telephone | 480-451-8150
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25180
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License Number State | AZ
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