Nicholas Tyler Russenberger, MPAS

NPI #1487435053 in Buffalo, Oklahoma

Provider Information

NPI Number: 1487435053
Entity Type: Individual
Name: Nicholas Tyler Russenberger, MPAS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: MPAS
Enumeration Date: Oct 10, 2023
Last Updated: Oct 10, 2023

Practice Location

Address: 1003 US HIGHWAY 64
City: Buffalo
State: Oklahoma
ZIP Code: 73834-8912
Phone: (580) 735-2555

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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