Individual
DR. RUSSELL A DEGROOTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 JEFFERSON WAY STE 101, KETCHIKAN, AK 99901-5953
(907) 247-9999
Mailing address
PO BOX 1099, WARD COVE, AK 99928-1099
(907) 247-9999
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
114055
AK
207X00000X
Orthopaedic Surgery Physician
26594
NE
207X00000X
Orthopaedic Surgery Physician
Primary
MD60661553
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1657661
—
AK
05
—
30471753
—
CO
Enumeration date
08/09/2006
Last updated
03/20/2026
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