Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
NICHOLAS TYLER RUSSENBERGER, MPAS
ActiveNICHOLAS TYLER RUSSENBERGER, MPAS is a Physician Assistant healthcare provider located in BUFFALO, Oklahoma. NPI 1487435053 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · BUFFALO, OK
Registration Details
- NPI Number
- 1487435053
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 10, 2023 (2.8366322693796 yrs)
- Last Updated
- Oct 10, 2023
- License
-
5175 (OK)
Practice Information
- Address
-
1003 US HIGHWAY 64BUFFALO, OK, 738348912Browse OK providers · Browse ZIP 73834
- Phone
- 5807352555
- Fax
- 5807352574
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in BUFFALO, OK
| Name | Credential | NPI |
|---|---|---|
| ROBERTA L DALEY | PA-C | 1164421434 |
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.