Organization
RUSSELL DEGROOTE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL A DEGROOTE (OWNER)
(360) 888-3381
Entity
Organization
Contact information
Practice address
25 JEFFERSON WAY STE 101, KETCHIKAN, AK 99901-5953
(907) 247-9999
Mailing address
PO BOX 1099, WARD COVE, AK 99928-1099
(907) 247-9999
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
26594
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51100231
—
CO
Enumeration date
12/06/2006
Last updated
03/12/2026
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