Individual
RUSSELL ADAM WHEELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4221 S WESTERN AVE, SUITE 5000, OKLAHOMA CITY, OK 73109-3447
(405) 644-5165
Mailing address
4221 S WESTERN AVE, SUITE 5000, OKLAHOMA CITY, OK 73109-3447
(405) 644-5165
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2058
OK
Other
Enumeration date
01/12/2012
Last updated
01/12/2012
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