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Luke Andrew Russell, PA

Physician Assistant in Columbia, SC. Individual provider (NPI-1).

NPI number1407366453
StatusActive
Last updated in NPPESOct 28, 2025

Details

NPI
1407366453
Entity type
Individual (NPI-1)
Name
Luke Andrew Russell
Credential
PA
Sex
Male
Sole proprietor
No
Enumeration date
Oct 4, 2017
Certification date
Oct 28, 2025
Last updated
Oct 28, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363A00000X Physician Assistant5749SCYes
363A00000X Physician Assistant–NE

Practice location

14 Richland Medical Park Dr Ste 350
Columbia, SC 29203-6896

Phone 803-434-1663 · Fax 803-434-7092

Mailing address

300 E McBee Ave Ste 300
Greenville, SC 29601-2899

Phone 864-522-8603

Other practice locations

7050 Air Depot Blvd Bldg 1040
Tinker Afb, OK 73145-8716

Phone 405-734-2778

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