Provider Demographics
NPI:1952416000
Name:BABBITT, RUSSELL III (MD)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:
Last Name:BABBITT
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 HANOVER ST
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-5444
Mailing Address - Country:US
Mailing Address - Phone:508-567-3520
Mailing Address - Fax:508-678-1537
Practice Address - Street 1:300 HANOVER ST
Practice Address - Street 2:SUITE 1-A
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-5444
Practice Address - Country:US
Practice Address - Phone:508-567-3202
Practice Address - Fax:508-678-1537
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2269702086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery