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NPI Code Detail

MEDICARE: DR. RUSSELL D ANDERSON D.C.

MEDICARE: DR. RUSSELL D ANDERSON D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor3418OK

General Provider Information

NPI Number : 1609097260
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RUSSELL D ANDERSON D.C.
Provider Business Mailing Address
First Line : 128 NORTH OAKWOOD ROAD
Second Line :
City : ENID
State : OK
Zip : 73703-4946
Country : US
Telephone Number : 580-234-2700
Fax Number : 580-234-3338
Provider Business Practice Location Address
First Line : 128 NORTH OAKWOOD ROAD
Second Line :
City : ENID
State : OK
Zip : 73703-4946
Country : US
Telephone Number : 580-234-2700
Fax Number : 580-234-3338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 07/08/2007

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Directions to “ DR. RUSSELL D ANDERSON D.C.” Practice Location

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