RICKY RUSSELL, M.D. LLC (NPI# 1912049487) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912049487 |
| Entity Type | Organization |
| Organization Name | RICKY RUSSELL, M.D. LLC |
| Practice Address |
501 Marshall St Suite 603 Jackson MS 39202-1651 |
| Practice Telephone | 6019859120 |
| Practice Fax Number | 6019859122 |
| Mailing Telephone | 6019859120 |
| Mailing Fax Number | 6019859122 |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2014-01-29 |
| Authorized Official Name | DR. RICKY GORDON RUSSELL (PHYSICIAN) |
| Authorized Official Telephone | 6019859120 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians |
| Street Address |
501 MARSHALL ST SUITE 603 |
| City | JACKSON |
| State | MS |
| Zip Code | 39202-1651 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932176641 | Sabra Sullivan | Dermatology | 501 Marshall St, Suite 606, Jackson, MS 39202-1651 | 2006-03-01 |
| 1598328684 | Caroline Douglass Peeples | Registered Nurse | 501 Marshall St, Jackson, MS 39202-1651 | 2019-04-15 |
| 1548655053 | Mississippi Urology Outpatient Surgery Center, LLC | Clinic/Center | 501 Marshall St, Suite 201, Jackson, MS 39202-1651 | 2015-04-01 |
| 1639586076 | Baptist Heart | Internal Medicine | 501 Marshall St, Suite 104, Jackson, MS 39202-1651 | 2014-07-17 |
| 1568709574 | Medical Foundation of Central Ms | Surgery | 501 Marshall St, Suite 500, Jackson, MS 39202-1651 | 2013-01-10 |
| 1417291451 | Urogyn Diagnostics LLC | Obstetrics & Gynecology | 501 Marshall St, Suite 600, Jackson, MS 39202-1651 | 2012-11-15 |
| 1548513617 | Southeast Urogyn LLC | Obstetrics & Gynecology | 501 Marshall St, Suite 600, Jackson, MS 39202-1651 | 2012-10-26 |
| 1477825800 | The Medical Foundation of Central Mississippi | Clinic/Center | 501 Marshall St, Suite 100, Jackson, MS 39202-1651 | 2012-02-01 |
| 1265712145 | Laurie Selman Nimon | Nurse Practitioner | 501 Marshall St, Suite 600, Jackson, MS 39202-1651 | 2011-08-23 |
| 1992034771 | Southeast Urogynecology Pa | Urology | 501 Marshall St, Suite 607-a, Jackson, MS 39202-1651 | 2009-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982234183 | Eva Mackenzie Carmody | Physician Assistant | 1190 N State St Suite 502, Jackson, MS 39202 | 2020-01-16 |
| 1750868691 | Katherine Walters | Nurse Practitioner | 501 Marshall St., Suite 400, Jackson, MS 39202 | 2018-07-24 |
| 1932638749 | Tylan Lee | Social Worker | 860 East River Place Suite 100, Jackson, MS 39202 | 2017-06-06 |
| 1417314725 | Euna Jyles | Counselor | 860 E River Pl, Jackson, MS 39202 | 2016-01-19 |
| 1255712048 | Edward Jonathan Breight | Specialist/Technologist | 1325 East Fortication Street, Jackson, MS 39202 | 2015-06-17 |
| 1881037703 | Kara Spinks Logan | Surgery | 1190 N State St Ste 502, Jackson, MS 39202 | 2013-04-10 |
| 1477876530 | Mick Inc. | Technician | 334 Josanna Street, Suite #209, Jackson, MS 39202 | 2010-03-03 |
| 1073724910 | Paul Frederic Dare | Anesthesiology | 1151 North State St., Suite 311, Jackson Anesthesia Associates, Jackson, MS 39202 | 2007-05-24 |
| 1225247703 | Lynn Kincannon Holland | Counselor | 911 Manship Street, Unit A, Jackson, MS 39202 | 2007-05-22 |
| 1457568149 | Incare Inc | Pulmonary Function Technologist | 1151 North State St, Suite 406, Jackson, MS 39202 | 2007-05-16 |
| Find all providers in zip 39202 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639532468 | Lee Finley Jones | Ophthalmology | 1501 Lakeland Dr Ste 100, Jackson, MS 39216-4869 | 2016-03-30 |
| 1861777161 | Parkside Eye Clinic P.C. | Ophthalmology | 2108 Fourth Street, Jackson, MI 49203-4518 | 2011-10-18 |
| 1043514607 | Jeevak Lal | Ophthalmology | 5887 N Rickfield Rd, Jackson, MI 49201-8314 | 2010-12-22 |
| 1447568241 | Laura L Dipuma | Ophthalmology | 2027 Greystone Sq, Jackson, TN 38305-3576 | 2010-09-15 |
| 1477879062 | James Arnold Luebbers | Ophthalmology | 687 East Kelly Ave., Bx 3797, Jackson, WY 83001-3797 | 2010-04-08 |
| 1366624801 | Premier Eye Care, Pllc | Ophthalmology | 30 Howell Ln, Jackson, KY 41339-8657 | 2007-11-27 |
| 1932224748 | Eyecare Professionals Pa | Ophthalmology | 1501 Lakeland Drive, Suite 100, Jackson, MS 39216-4848 | 2007-03-20 |
| 1053410126 | Ophthalmic Plastic Surgery Specialists Pllc | Ophthalmology | 1421 North State St, Ste 304, Jackson, MS 39202 | 2006-09-22 |
| 1114020906 | James Alvin Bruce Jr. | Ophthalmology | 2500 Lakeland Dr, Ste A, Jackson, MS 39232 | 2006-09-06 |
| 1639272693 | Charles Gerard Sherwood | Ophthalmology | 1500 Woodrow Wilson Ave, G. V. 'sonny' Montgomery Va Medical Center, Jackson, MS 39216 | 2006-09-06 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.