Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. RUSSELL L PRIDGEN
Active Sole ProprietorMR. RUSSELL L PRIDGEN is a Contractor healthcare provider located in WINDER, Georgia. NPI 1528424579 is currently active in the NPPES registry. Verify at CMS.
Contractor · WINDER, GA
Registration Details
- NPI Number
- 1528424579
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 6, 2016 (10.637242962703 yrs)
- Last Updated
- Jun 5, 2016
- License
-
057447391 (GA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
588 KRISTIN LNWINDER, GA, 306803247Browse GA providers · Browse ZIP 30680
- Phone
- 4103751996
- Fax
- 7708671651
- Primary Specialty
-
Contractor
171W00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.