Russell Kohl , Md, Pllc

NPI #1538238761 in Vinita, Oklahoma

Provider Information

NPI Number: 1538238761
Entity Type: Organization
Organization Name: Russell Kohl , Md, Pllc
Primary Specialty: Family Medicine
Enumeration Date: Nov 6, 2006
Last Updated: Oct 29, 2010

Practice Location

Address: 803 N FOREMAN ST
City: Vinita
State: Oklahoma
ZIP Code: 74301-1412
Phone: (918) 256-2257

Authorized Official

Name: DR. RUSSELL WADE KOHL, MD
Title: MANAGING MEMBER
Phone: (918) 265-2257

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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