Individual
DR. JOE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3100
(918) 458-3610
Mailing address
PO BOX 1008, TAHLEQUAH, OK 74465-1008
(918) 458-2406
(918) 456-8886
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6050
OK
Other
Enumeration date
06/17/2015
Last updated
03/23/2021
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