# RUSSELL KOHL , MD, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538238761
- **Authorized official:** DR. RUSSELL WADE KOHL MD (MANAGING MEMBER)
- **Authorized official phone:** (918) 265-2257

## Contact information

- **Practice address:** 803 N FOREMAN ST, VINITA, OK 74301-1412
- **Practice address phone:** (918) 256-2257
- **Practice address fax:** (918) 256-2316
- **Mailing address:** 803 N FOREMAN ST, VINITA, OK 74301-1412
- **Mailing address phone:** (918) 256-2257
- **Mailing address fax:** (918) 256-2316

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 22918 | OK | Yes |

## Other

- **Enumeration date:** 11/06/2006
- **Last updated:** 10/29/2010