Organization
RUSSELL KOHL , MD, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL WADE KOHL MD (MANAGING MEMBER)
(918) 265-2257
Entity
Organization
Contact information
Practice address
803 N FOREMAN ST, VINITA, OK 74301-1412
(918) 256-2257
(918) 256-2316
Mailing address
803 N FOREMAN ST, VINITA, OK 74301-1412
(918) 256-2257
(918) 256-2316
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22918
OK
Other
Enumeration date
11/06/2006
Last updated
10/29/2010
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