Russell Stackhouse MD PA
Russell Stackhouse MD PA is an Ophthalmology Physician in Fernandina, Florida. Licensed in Florida. Registered with an NPI since 2018.
- Licensed in
- FL
- In the registry since
- 2018
- Specialties on file
- 2
What do these letters mean?
- PA — Professional association
- A form of business registration, not a clinical qualification.
Practice location Address checks out
6 S 14th StFernandina, FL 32034-3212
Phone: (904) 261-5741
Fax: (904) 261-7383
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Ophthalmology Physician (primary) | Taxonomy 207W00000X · Licence ME117902 (FL) |
|---|---|
| Orthopaedic Foot and Ankle Surgery Physician | Taxonomy 207XX0004X |
Record details
| NPI number | 1538655014 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Nichole Barnett — Practice Administrator · (904) 261-5741 |
| Other names | Coastal Vision Center |
| NPI enumerated | July 8, 2018 |
| Last updated in NPPES | December 13, 2022 |
| Certification date | December 13, 2022 |
| Mailing address | 6 S 14th St, Fernandina, FL 32034-3212 |
Other providers in Fernandina
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James Russell Keller Stackhouse, MD
6 S 14th St, Fernandina, FL 32034 · (904) 261-5741