Individual
MS. JANET ELAINE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1145 S UTICA AVE, SUITE 364, TULSA, OK 74104-4000
(918) 712-5000
(918) 592-0286
Mailing address
1145 S UTICA AVE, SUITE 364, TULSA, OK 74104-4000
(918) 712-5000
(918) 592-0286
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
20294
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100101420A
—
OK
01
—
247235002
PTAN
—
01
—
P00158400
MEDICARE RAILROAD CARRIER
—
Enumeration date
08/02/2006
Last updated
10/12/2016
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