BRYAN S RUSSELL DPM FACFAS NPI 1700854825

NPI Information

  • NPI: 1700854825
  • Provider Name: BRYAN S RUSSELL, DPM FACFAS
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Individual
  • Address: 55 WHITCHER ST
    STE. 450
    MARIETTA, GA
    ZIP 30060
  • Phone: (770) 590-4188

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NPI Details

Bryan S Russell, DPM FACFAS is a foot and ankle surgery podiatrist in Marietta, GA. Bryan S Russell, DPM FACFAS NPI is 1700854825. 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:

55 WHITCHER ST
STE. 450
MARIETTA, GA
ZIP 30060
Phone: (770) 590-4188
Fax: (770) 590-4189

The enumeration date for this NPI number is 3/14/2006 and was last updated on 10/30/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatristPOD001261GEORGIANo
2213ES0103XPodiatristFoot & Ankle SurgeryPOD001261GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10003150721CMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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