Provider Demographics
NPI:1801545512
Name:PLATT, RUSSELL LINDBERGH III (DPM)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:LINDBERGH
Last Name:PLATT
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:704-633-6442
Mailing Address - Fax:336-716-9253
Practice Address - Street 1:605 GROVE ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-3233
Practice Address - Country:US
Practice Address - Phone:704-633-6442
Practice Address - Fax:336-716-9253
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC868213ES0000X, 213E00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program