| NPI Details | |
|---|---|
| NPI | 1043215809 |
| Gender | Male |
| Enumeration Date | 06/17/2005 |
| Last Updated | 03/12/2012 |
| Entity Type | Individual |
| Active | Over 11 years ago |
| Practice Location | |
|---|---|
| 7301 E 2ND ST STE 308 SCOTTSDALE AZ, 85251-5627, US |
|
| Phone | (480) 949-1212 |
| Fax | (480) 994-5633 |
| Business Location | |
|---|---|
| 7301 E 2ND ST STE 308 SCOTTSDALE AZ, 85251-5627, US |
|
| Phone | (480) 994-5633 |
| Fax | (480) 994-5633 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 208800000X |
| License State | Arizona |
| License Number | 25459 |
| Remove 1043215809 NPI Number | |
According to our database, Byron Dale Russell MD NPI is 1043215809, taxonomy code is 208800000X and license number is 25459, license state is located at Arizona. Byron Dale Russell MD physically located at 7301 E 2nd St, Scottsdale AZ, 85251-5627. NPI Number Byron Dale Russell MD has the Individual type.
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1043215809 NPI number is provided on an as is basis without warranty of any kind. 1043215809 is maintained by the National Plan & Provider Enumeration System. The contents of Byron Dale Russell MD are for informational purposes only.
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