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1902216740
RUSSELL PHILIP LIBBY
BRISTOL, TN
NPI
1902216740
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208800000X Urology
(Licence: TX S5214)
Additional Taxonomies
208800000X Urology
(Licence: TN 70724)
Enumeration Date
2014-05-02
Last Update Date
2024-03-13
Business Address
RUSSELL PHILIP LIBBY MD
1 MEDICAL PARK BLVD
BRISTOL, TN 37620-7430
Phone number: 423-844-1211
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Mailing Address
RUSSELL PHILIP LIBBY MD
1021 W OAKLAND AVE STE 310
JOHNSON CITY, TN 37604-2192
Phone number: 423-302-6565
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