MEDICARE: RUSSELL N OAKLEY M.D.

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
1	207X00000X	Orthopaedic Surgery Physician	MD00029618	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962402875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUSSELL N OAKLEY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 421
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99210-0421
Country	:	US
Telephone Number	:	866-747-2455
Fax Number	:

Provider Business Practice Location Address
First Line	:	212 E CENTRAL AVE
Second Line	:	SUITE 245
City	:	SPOKANE
State	:	WA
Zip	:	99208-6291
Country	:	US
Telephone Number	:	509-252-1977
Fax Number	:	509-465-3026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	09/30/2015

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