Russell Eugene Fothergill M.D.

NPI 1063472504 - Obstetrics & Gynecology - 207V00000X

NPI Details
NPI 1063472504
Gender Male
Enumeration Date 03/27/2006
Last Updated 07/11/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
2401 S 31ST ST
TEMPLE TX, 76508-0001, US
Phone (254) 724-2111
Business Location
PO BOX 847408
DALLAS TX, 75284-7408, US
Phone (254) 724-2111
Taxonomy Code 207V00000X
License State Texas
License Number L2890
Remove 1063472504 NPI Number

According to our database, Dr. Russell Eugene Fothergill M.D. NPI is 1063472504, taxonomy code is 207V00000X and license number is L2890, license state is located at Texas. Russell Eugene Fothergill M.D. physically located at 2401 S 31st St, Temple TX, 76508-0001. NPI Number Russell Eugene Fothergill M.D. has the Individual type.

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1063472504 NPI number is provided on an as is basis without warranty of any kind. 1063472504 is maintained by the National Plan & Provider Enumeration System. The contents of Russell Eugene Fothergill M.D. are for informational purposes only.