Russell Lee Carlisle, DO Valid NPI
Individual provider · Family Medicine Physician · Wesson, MS
- NPI
- 1689263717
- Type
- Individual (Type 1)
- Primary specialty
- Family Medicine Physician (Family Medicine)
- Specialty group
- Allopathic & Osteopathic Physicians
- Taxonomy code
- 207Q00000X
- License number
- 15093 (MS)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2021-01-13
- Last updated
- 2021-01-13
Practice location
10058 Sylvarena Rd
Wesson, MS 39191-9055
(601) 757-5791