IndividualActive
Robert Russ, S.T.S.A.
NPI 1851610554 · Surgical Technologist · Lakeside, AZ
Provider details
- NPI number
- 1851610554
- Entity type
- Individual
- Primary specialty
- Surgical TechnologistTechnologists, Technicians & Other Technical Service Providers
- Credential
- S.T.S.A.
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Technologists, Technicians & Other Technical Service Providers
Practice location
420 W Billy Creek Dr
Lakeside, AZ 85929-6830
Phone: (928) 369-8117
Approximate (ZIP-level) locationGet directions
Mailing address
420 W Billy Creek Dr
Lakeside, AZ 85929-6830
Registry dates
- Enumerated
- 2010-05-20
- Last updated
- 2010-05-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.