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

Individual provider Surgery Physician · NPI 1104823475

Dr. W Randall Russell, MD is a General Surgery in Wynnewood, Pennsylvania. Graduated from Jefferson Medical College of Thomas Jefferson University in 1983, 43 years ago. Practices with Main Line Healthcare, a 1,153-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
43
Trained at
Jefferson Medical College of Thomas Jefferson University
Licensed in
PA
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

100 E Lancaster Ave Ste 151 Lankenau Mob East
Wynnewood, PA 19096-3450
Phone: (484) 476-6492
Fax: (484) 476-8147
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence MD032388E (PA)

Record details

NPI number1104823475
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 1, 2005
Last updated in NPPESMarch 27, 2015

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Also practisesUNDERSEA AND HYPERBARIC MEDICINE
Medical schoolJEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
Graduated 1983 (43 years in practice)
Group practice Main Line Healthcare — 1153 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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