Individual
RUSSELL DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
717 S HOUSTON AVE STE 400, TULSA, OK 74127-9007
(918) 382-4600
Mailing address
1331 E PURDUE AVE APT A, PHOENIX, AZ 85020-6233
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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