Individual
RUSSELL EUGENE KOCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
820 WALL ST, NORMAN, OK 73069
(405) 928-2044
(405) 928-2049
Mailing address
820 WALL STREET, NORMAN, OK 73069
(405) 928-2044
(405) 928-2049
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
602
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100838010A
—
OK
Enumeration date
09/20/2006
Last updated
04/13/2011
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