Individual
DR. RUSSELL BRYANT KERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
101 S MOORE AVE, CLAREMORE, OK 74017-5047
(918) 342-6656
Mailing address
101 S MOORE AVE, CLAREMORE, OK 74017-5047
(918) 342-6656
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
15194
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15194
PHARMACY LICENSE NUMBER
OK
Enumeration date
11/27/2012
Last updated
11/27/2012
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