Russell, Dallas M

Russell, Dallas M is an individual health care provider with primary practice located at 790 Montclair Rd Ste 210, Birmingham AL 35213-1966. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Neurology. Other Service Providers / Specialist is his primary health care specialty. Russell, Dallas M can be contacted via phone (205) 595-3600.

Contact Information

Primary practice address
790 Montclair Rd Ste 210 Birmingham AL 35213-1966
Phone: (205) 595-3600
Fax: (205) 595-3663
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 12098 Alabama
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 12098 Alabama

Profile Details

NPI number 1609879253
LBN Legal business name Russell, Dallas M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Mar 20th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609879253 NPPES
Alabama MEDICAID 5290002380

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