Organization
WARREN K RUSSELL PH D P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WARREN K RUSSELL PH.D. (PRESIDENT)
(405) 415-2302
Entity
Organization
Contact information
Practice address
717 NW 56TH ST, OKLAHOMA CITY, OK 73118-6030
(405) 415-2302
(405) 415-2301
Mailing address
717 NW 56TH ST, OKLAHOMA CITY, OK 73118-6030
(405) 415-2302
(405) 415-2301
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
753
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
442526116001
BCBS OF OKLAHOMA
OK
Enumeration date
12/14/2006
Last updated
03/05/2008
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