Provider Demographics
NPI:1710390927
Name:RUSSELL, RACHEL (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:RUSSELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 MICCOSUKEE RD
Mailing Address - Street 2:TALLAHASSEE MEMORIAL HOSPITALISTS GROUP
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5054
Mailing Address - Country:US
Mailing Address - Phone:850-431-4556
Mailing Address - Fax:850-431-6315
Practice Address - Street 1:1300 MICCOSUKEE RD
Practice Address - Street 2:HOSPITALISTS GROUP
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5054
Practice Address - Country:US
Practice Address - Phone:850-431-4556
Practice Address - Fax:850-431-6315
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2017-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME132744207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine