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MR. RUSSELL E COTTON PAC

Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1417946930

Individual Registrant:
MR. RUSSELL E COTTON PAC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
7 WESTERN BYP  CLAYTON, AL 36016-2013 US
Tel: 334-775-3235  Fax: 334-775-8067

Contact information for business:
1414 ELBA HWY  TROY, AL 36079-6020 US
Tel: 334-670-6726  Fax: 334-670-6731

Registration Information:
NPI: 1417946930
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Medical
GA003391

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
STATE LICENSEPA237AL01
631802047AL05




HEALTH CARE JOBS AL - Page 1



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