MEDICARE: DR. GARY NELSON RUSSELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	14702	AL
2	207X00000X	Orthopaedic Surgery Physician	14702	AL

General Provider Information

NPI Number	:	1588662431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY NELSON RUSSELL

Provider Business Mailing Address
First Line	:	2950 HIGHWAY 78 E
Second Line	:
City	:	JASPER
State	:	AL
Zip	:	35501-8903
Country	:	US
Telephone Number	:	205-221-5374
Fax Number	:	205-384-1453

Provider Business Practice Location Address
First Line	:	2950 HIGHWAY 78 E
Second Line	:
City	:	JASPER
State	:	AL
Zip	:	35501-8903
Country	:	US
Telephone Number	:	205-221-5374
Fax Number	:	205-384-1453

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	02/10/2021

Similar Medicare Providers

1114925237 — DR. KENDALL CHARLES VAGUE M.D.
Practice Location Address:

2950 HIGHWAY 78 E
JASPER, AL
35501-8903

Practice Phone: 205-221-5374
Practice Fax: 205-384-1453

1720086861 — DR. MARK ALAN PREVOST MD
Practice Location Address:

2950 HIGHWAY 78 E
JASPER, AL
35501-8903

Practice Phone: 205-221-5374
Practice Fax: 205-385-0382

1861479388 — MR. MICHAEL LANE JONES P.T.
Practice Location Address:

2980 HIGHWAY 78 E
JASPER, AL
35501-8903

Practice Phone: 205-384-1941
Practice Fax: 205-384-6362

1699752618 — MRS. LYNN LIBERTE MOSLEY P.T.
Practice Location Address:

2980 HIGHWAY 78 E
JASPER, AL
35501-8903

Practice Phone: 205-384-1941
Practice Fax: 205-384-6362

1699752600 — MR. ROBERT DARRELL BAUGHN P.T.
Practice Location Address:

2980 HIGHWAY 78 E
JASPER, AL
35501-8903

Practice Phone: 205-384-1941
Practice Fax: 205-384-6362

1275510299 — MR. JERROD DOUGLAS WALKER P.T.
Practice Location Address:

2980 HIGHWAY 78 E
JASPER, AL
35501-8903

Practice Phone: 205-384-1941
Practice Fax: 205-384-6362

Directions to “ DR. GARY NELSON RUSSELL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.