BRANDON RUSSELL

FORT WAYNE, IN
NPI1588603708
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: OH  34C.000055)
Additional Taxonomies207P00000X Emergency Medicine
(Licence: IN  02003088)
Enumeration Date2006-06-05
Last Update Date2022-12-20
Business Address
BRANDON RUSSELL D.O.
3640 NEW VISION DRIVE
FORT WAYNE, IN 46845-1717
Phone number: 260-482-4440
Mailing Address
BRANDON RUSSELL D.O.
416 E MAUMEE ST
ANGOLA, IN 46703-2015
Phone number: 260-665-2141