Provider Demographics
NPI:1528248960
Name:ALLMAN, RUSSELL ELBEY JR (MD)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:ELBEY
Last Name:ALLMAN
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1330
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39502-1330
Mailing Address - Country:US
Mailing Address - Phone:228-864-4392
Mailing Address - Fax:228-868-7103
Practice Address - Street 1:14231 SEAWAY RD STE 5003
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4660
Practice Address - Country:US
Practice Address - Phone:228-864-4392
Practice Address - Fax:228-868-7103
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2017-11-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO20120118012085R0202X
MS226142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology