Basic Information
| Provider Information | |||||||||
| NPI: | 1518278126 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOODE | ||||||||
| FirstName: | RUSSELL | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 86144 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366896144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514765050 | ||||||||
| FaxNumber: | 2514502770 | ||||||||
| Practice Location | |||||||||
| Address1: | 1720 SPRING HILL AVE FL 3 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366041410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2514352663 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/29/2010 | ||||||||
| LastUpdateDate: | 07/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 31474 | AL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.