Sam O Russell III OD

NPI 1063479111 - Optometrist - 152W00000X

NPI Details
NPI 1063479111
Gender Male
Enumeration Date 05/01/2006
Last Updated 04/24/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
240 W EVANS ST
FLORENCE SC, 29501-3428, US
Phone (843) 662-3278
Fax (843) 667-6090
Business Location
240 W EVANS ST
FLORENCE SC, 29501-3428, US
Phone (843) 662-3278
Fax (843) 667-6090
Toxanomy
Taxonomy Code 152W00000X
License State South Carolina
License Number 601
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According to our database, Dr. Sam O Russell III OD NPI is 1063479111, taxonomy code is 152W00000X and license number is 601, license state is located at South Carolina. Sam O Russell III OD physically located at 240 W Evans St, Florence SC, 29501-3428. NPI Number Sam O Russell III OD has the Individual type.

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1063479111 NPI number is provided on an as is basis without warranty of any kind. 1063479111 is maintained by the National Plan & Provider Enumeration System. The contents of Sam O Russell III OD are for informational purposes only.