Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Paul H Russo, MD

Individual provider Family Medicine Physician · NPI 1164488458

Dr. Paul H Russo, MD is a Family Practice in Kaukauna, Wisconsin. Graduated from Southern Illinois University School of Medicine in 1987, 39 years ago. Practices with Kaukauna Clinic, SC, an 8-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
39
Trained at
Southern Illinois University School of Medicine
Licensed in
WI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

305 E 12th St
Kaukauna, WI 54130-2865
Phone: (920) 766-4656
Fax: (920) 766-4659
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 0029508 (WI)

Record details

NPI number1164488458
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 25, 2006
Last updated in NPPESNovember 26, 2014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolSOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE
Graduated 1987 (39 years in practice)
Group practice Kaukauna Clinic, S.C. — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Kaukauna