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Contact Information

BRYAN S RUSSELL, DPM FACFAS
55 WHITCHER ST
STE. 450
MARIETTA, GA30060
 Phone: 770-590-4188
 Fax: 770-590-4189
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
 

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for BRYAN S RUSSELL · (Male)

NPI Number 1700854825
Status Active
Credentials DPM FACFAS
Entity Individual
Enumeration date 03/14/2006
Last updated 10/30/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • GA License # POD001261
  • GA Medicaid 0003150721C
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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