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Individual

DR. RUSSELL WAYNE JEFFERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
501 S 11TH ST, CLINTON, OK 73601-4303
(580) 819-0082
Mailing address
501 S 11TH ST, CLINTON, OK 73601-4303
(580) 819-0082

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
6428
OK
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/01/2017
Last updated
07/21/2022
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