DR. Matthew Edward Russ, DMD is a student in an organized health care education training program in Jackson, MS. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Matthew Edward Russ, DMD NPI is 1588126395. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
2500 N STATE ST
JACKSON, MS
ZIP 39216-500
Phone: (601) 815-9934
The NPI 1588126395 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).
The enumeration date for this NPI number is 4/1/2019 and was last updated on 4/23/2020.