Individual
DR. RUSSELL DALE MONEYPENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10512 N 110TH EAST AVE, SUITE 300, OWASSO, OK 74055-6636
(918) 376-8900
(918) 376-8990
Mailing address
10512 N 110TH EAST AVE, SUITE 300, OWASSO, OK 74055-6636
(918) 376-8900
(918) 376-8990
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3680
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100252140A
—
OK
Enumeration date
07/04/2006
Last updated
05/06/2014
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