Russell, Anthony Otis

Russell, Anthony Otis is an individual health care provider with primary practice located at 1633 Physicians Dr , Tallahassee FL 32308-4620. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Russell, Anthony Otis can be contacted via phone (850) 431-3276.

Contact Information

Primary practice address
1633 Physicians Dr Tallahassee FL 32308-4620
Phone: (850) 431-3276
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X ME127853 Florida
Allopathic & Osteopathic Physicians / Addiction Medicine 207LA0401X ME127853 Florida
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X ME127853 Florida
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X ME127853 Florida

Profile Details

NPI number 1467454322
LBN Legal business name Russell, Anthony Otis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Sep 15th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467454322 NPPES
Florida MEDICAID 018286400

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