Russell Wayne Anderson, DO
Emergency Medicine in Tulsa, OK. Individual provider (NPI-1).
NPI number1114939733
StatusActive
Last updated in NPPESOct 30, 2007
Details
- NPI
- 1114939733
- Entity type
- Individual (NPI-1)
- Name
- Russell Wayne Anderson
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 12, 2006
- Last updated
- Oct 30, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 4498 | OK | Yes |
| 207P00000X | Emergency Medicine | 056948 | GA |
Practice location
4500 S Garnett RdSte 919
Tulsa, OK 74146-5229
Phone 918-728-6145 · Fax 918-728-6146
Mailing address
4500 S Garnett RdSte 919
Tulsa, OK 74146-5229
Phone 918-728-6145 · Fax 918-728-6146
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