Russell B Roth MD Pllc

NPI #1073773735 in Muskogee, Oklahoma

Provider Information

NPI Number: 1073773735
Entity Type: Organization
Organization Name: Russell B Roth MD Pllc
Primary Specialty: Specialist
Enumeration Date: Jun 16, 2008
Last Updated: Mar 25, 2011

Practice Location

Address: 3401 W BROADWAY ST
City: Muskogee
State: Oklahoma
ZIP Code: 74401-2136
Phone: (918) 687-5477

Authorized Official

Name: DR. RUSSELL B ROTH, MD
Title: OWNER
Phone: (918) 687-5477

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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