Provider Demographics
NPI:1164794327
Name:RUSSELL N. FERRELL, D.C.
Entity Type:Organization
Organization Name:RUSSELL N. FERRELL, D.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:N
Authorized Official - Last Name:FERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-427-7606
Mailing Address - Street 1:1144 BRYAN DR
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-3601
Mailing Address - Country:US
Mailing Address - Phone:205-989-4950
Mailing Address - Fax:
Practice Address - Street 1:4524 SOUTHLAKE PKWY
Practice Address - Street 2:SUITE 4
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3270
Practice Address - Country:US
Practice Address - Phone:205-989-4950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1475261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service