Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. RUSSELL JOHN GREEN, MD
Active Sole ProprietorDR. RUSSELL JOHN GREEN, MD is a Preventive Medicine healthcare provider located in OWASSO, Oklahoma. NPI 1003928532 is currently active in the NPPES registry. Verify at CMS.
Preventive Medicine · OWASSO, OK
Registration Details
- NPI Number
- 1003928532
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 31, 2006 (19.975058252255 yrs)
- Last Updated
- Jul 13, 2009
- License
-
17587 (OK)
- Sole Proprietor
- Yes
Practice Information
- Address
-
8751 N 117TH EAST AVEUNIT HOWASSO, OK, 740552098Browse OK providers · Browse ZIP 74055
- Phone
- 9186091600
- Fax
- 9186091319
- Primary Specialty
-
Preventive Medicine
2083P0500X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.