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Contact Information

JEFFREY L RUSSELL, DPM
RR 1 BOX 34-A
WATONGA, OK73772-9706
 Phone: 580-623-4991
 Fax: 580-623-5490
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JEFFREY L RUSSELL · (Male)

NPI Number 1942309034
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 09/22/2006
Last updated 07/09/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • FL License # PO2966
  • OK Medicaid 9102966
Hospital affiliation(s)
  • USPHS LAWTON INDIAN HOSPITAL - (Acute Care)
    1515 LAWRIE TATUM ROAD
    LAWTON, OK 73507
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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