Russell, Renee Jean
Russell, Renee Jean is an individual health care provider with primary practice located at 1110 Neo Loop , Grove OK 74344-6046. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Russell, Renee Jean can be contacted via phone (918) 786-3100.Contact Information
Primary practice address
1110 Neo Loop
Grove OK 74344-6046
Phone: (918) 786-3100
Fax: (918) 786-3108
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 22021 | Oklahoma |
Profile Details
| NPI number | 1245286921 |
|---|---|
| LBN Legal business name | Russell, Renee Jean |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2006 |
| Last updated | Jan 12th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245286921 | NPPES |
| Oklahoma | MEDICAID | 100017290D | |
| Oklahoma | MEDICAID | 100017290E |
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