Individual
CHARLES MCPHERRIN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6301 NW QUANNAH PARKER TRL, LAWTON, OK 73505-1326
(580) 510-0357
Mailing address
503 4TH ST APT B, ELGIN, OK 73538-9232
(580) 513-1331
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18872
OK
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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