Individual
DR. RUSSELL JOHN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8751 N 117TH EAST AVE, UNIT H, OWASSO, OK 74055-2098
(918) 609-1600
(918) 609-1319
Mailing address
8751 N 117TH EAST AVE, UNIT H, OWASSO, OK 74055-2098
(918) 609-1600
(918) 609-1319
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
17587
OK
Other
Enumeration date
08/31/2006
Last updated
07/13/2009
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