Organization · Type 2 NPI
Russell L. Carlisle, D.o.
Primary Care Clinic/Center · Brandon, MS
NPI number
1528459526
Active
Practice location
333 Willow Ridge Cv
Brandon, MS 39047-8089
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | 15093 (MS) |
Primary Care Clinic/Center: Definition to come...
About NPI 1528459526
Russell L. Carlisle, D.o.'s National Provider Identifier is 1528459526, issued on Feb 11, 2015. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Brandon, MS. The record was last updated on Feb 11, 2015.