DR. Russell Crockett Woglom, MD

NPI #1417923434 in Corning, New York

Provider Information

NPI Number: 1417923434
Entity Type: Individual
Name: DR. Russell Crockett Woglom, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Internal Medicine
Credential: MD
Enumeration Date: Feb 28, 2006
Last Updated: Mar 3, 2021

Practice Location

Address: 130 CENTER WAY
City: Corning
State: New York
ZIP Code: 14830-2255
Phone: (607) 936-9971

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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