DR. DUANE L. RUSSELL (NPI# 1962408658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962408658 |
| Entity Type | Individual |
| Full Name | DR. DUANE L. RUSSELL |
| Credential | M.D. |
| Practice Address |
117 S 11th Ave Laurel MS 39440-4312 |
| Practice Telephone | 6014253033 |
| Practice Fax Number | 6014286561 |
| Mailing Telephone | 6014253033 |
| Mailing Fax Number | 6014286561 |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2007-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 173000000X | Legal Medicine | 017375 | MS | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 0124892 | 05 |
| Street Address |
117 S 11TH AVE |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831195536 | Gayla B. Glenn | Dietitian, Registered | 117 S 11th Ave, Laurel, MS 39440-4312 | 2005-06-27 |
| 1932739034 | Family Health Center, Inc. | Bus | 117 S 11th Ave, Laurel, MS 39440-4312 | 2020-01-17 |
| 1508406802 | Jessica Lynn Anderson | Nurse Practitioner | 117 S 11th Ave, Laurel, MS 39440-4312 | 2020-01-14 |
| 1093373110 | Sarah Nicole Thames | Nurse Practitioner | 117 S 11th Ave, Laurel, MS 39440-4312 | 2019-06-04 |
| 1386197697 | Scott Fowler | Nurse Practitioner | 117 S 11th Ave, Laurel, MS 39440-4312 | 2016-08-03 |
| 1477919603 | Family Health Center, Inc. | Clinic/Center | 117 S 11th Ave, Laurel, MS 39440-4312 | 2016-01-04 |
| 1649666744 | Sheree Lamara Conley-donaldson | Nurse Practitioner | 117 S 11th Ave, Laurel, MS 39440-4312 | 2015-04-15 |
| 1548656614 | Lashundra Shanett Speights | Nurse Practitioner | 117 S 11th Ave, Laurel, MS 39440-4312 | 2015-04-15 |
| 1245648104 | Casey Herrington | Nurse Practitioner | 117 S 11th Ave, Laurel, MS 39440-4312 | 2014-07-23 |
| 1497187512 | Felicia Keys | Nurse Practitioner | 117 S 11th Ave, Laurel, MS 39440-4312 | 2013-07-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 173000000X |
| Grouping | Other Service Providers |
| Classification | Legal Medicine |
| The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275539017 | Bernard G. De Asis | Legal Medicine | 117 South 11th Avenue, Laurel, MS 39440 | 2005-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285915686 | William Edward Bowlus | Legal Medicine | 24 Wimbledon Dr, Jackson, MS 39211-2443 | 2011-08-30 |
| 1215193933 | The Clinic At Elm Lake, P.a. | Legal Medicine | 3700 N Frontage Rd, Columbus, MS 39701 | 2008-08-01 |
| 1548315203 | Guardian Angel Healthcare II, Inc. | Legal Medicine | 347 Magnolia Dr, Raleigh, MS 39153-6011 | 2007-01-24 |
| 1659466563 | Mid Delta Family Practice Clinic | Legal Medicine | 403 S Davis Ave, Cleveland, MS 38732-3411 | 2006-10-04 |
| 1952497422 | Charles H Williams | Legal Medicine | 1000 Lakeland Square Ext., Suite 800, Flowood, MS 39232-7649 | 2006-10-04 |
| 1770596918 | Jessie R Taylor | Legal Medicine | 1423 Palmetto Road, Verona, MS 38879 | 2006-08-15 |
| 1538170683 | Shanti Pandey | Legal Medicine | 821 Main St, Fayette, MS 39069-0008 | 2006-08-11 |
| 1437184017 | William H. Wallace | Legal Medicine | 1421 N State St # St.1, Ste. 504, Jackson, MS 39202-1658 | 2006-07-11 |
| 1184656068 | Robert Allen Smith | Legal Medicine | 1424 N. State St., Ste. 504, Jackson, MS 39202-1658 | 2006-07-07 |
| 1568459089 | River Bend Medical Clinic, Inc | Legal Medicine | 2659 Lakeland Dr, Flowood, MS 39232-9516 | 2005-09-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.