Dr. Kathryn White Russell, MD
Surgery, Pediatric Surgery in Philadelphia, PA. Individual provider (NPI-1).
NPI number1750518049
StatusActive
Last updated in NPPESNov 17, 2021
Details
- NPI
- 1750518049
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kathryn White Russell
- Credential
- MD
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 15, 2009
- Certification date
- Nov 17, 2021
- Last updated
- Nov 17, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - GENERAL SURGERY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086S0120X | Surgery, Pediatric Surgery | MT207856 | PA | Yes |
Practice location
3401 Civic Center BlvdDivision Of Pediatric Surgery
Philadelphia, PA 19104-4319
Phone 215-590-1190
Mailing address
3401 Civic Center BlvdDivision Of Pediatric Surgery
Philadelphia, PA 19104-4319
Phone 215-590-1190
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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