Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JERROLD C RUSSELL, OD
ActiveJERROLD C RUSSELL, OD is a Optometrist healthcare provider located in COLUMBUS, Wisconsin. NPI 1679526990 is currently active in the NPPES registry. Verify at CMS.
Optometrist · COLUMBUS, WI
Registration Details
- NPI Number
- 1679526990
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 18, 2006 (20.213312581541 yrs)
- Last Updated
- Jan 22, 2016
- License
-
2029-035 (WI)
Practice Information
- Address
-
1341 PARK AVECOLUMBUS, WI, 539251614Browse WI providers · Browse ZIP 53925
- Phone
- 9206232431
- Fax
- 9206233656
- Primary Specialty
-
Optometrist
152W00000X
Other Optometrist Providers in COLUMBUS, WI
| Name | Credential | NPI |
|---|---|---|
| JAMIE L BLAVAT | OD | 1073034609 |
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.