Individual
DR. JAMES FRANK RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3431 S BOULEVARD ST, SUITE 105, EDMOND, OK 73013-5475
(405) 340-1200
Mailing address
6448 BRANDYWINE LN, OKLAHOMA CITY, OK 73116-3520
(405) 810-1090
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
812
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
812
STATE LICENSE
OK
Enumeration date
05/31/2007
Last updated
07/08/2007
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