DR. RUSSELL WAYNE JEFFERSON (NPI# 1073041299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073041299 |
| Entity Type | Individual |
| Full Name | DR. RUSSELL WAYNE JEFFERSON |
| Credential | DO |
| Practice Address |
501 S 11th St Clinton OK 73601-4303 |
| Practice Telephone | 5808190082 |
| Mailing Telephone | 5808190082 |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2020-04-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 6428 | OK | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4 E Clark Bass Blvd Ste 301, Mcalester, OK 745014269 | (918) 421-6081 |
| Street Address |
501 S 11TH ST |
| City | CLINTON |
| State | OK |
| Zip Code | 73601-4303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225514458 | April Walker | Pharmacist | 100 N. 30th, Clinton, OK 73601 | 2018-07-11 |
| 1477045995 | Dynamic Psychological & Mediation Services | Counselor | 104 S 7th St, Clinton, OK 73601 | 2018-05-31 |
| 1619490851 | Kristyn Wagner | Social Worker | 90 N 31st Street, Clinton, OK 73601 | 2017-07-19 |
| 1124478193 | Lindsay Dlugonski | Nurse Practitioner | 545 S. 30th Street, Clinton, OK 73601 | 2016-06-20 |
| 1881059434 | Cathrine Mears | Counselor | 94 N 31st, Clinton, OK 73601 | 2015-12-28 |
| 1326464603 | Melissa Lucia Torres | Nurse Practitioner | 3140 W. Hayes, Clinton, OK 73601 | 2014-03-11 |
| 1356789341 | Clinton Hmpn, LLC | Family Medicine | 129 S. 9th Street, Clinton, OK 73601 | 2013-06-12 |
| 1881950970 | Namen Bouma | Counselor | 70-100 N. 31st Street, Clinton, OK 73601 | 2012-04-03 |
| 1366717928 | Sherri Lee Milliron | Counselor | 70-100 N 31st, Clinton, OK 73601 | 2012-03-15 |
| 1740597087 | Susan Kathleen Hodges | Counselor | 19 Sunset Place, Clinton, OK 73601 | 2010-09-08 |
| Find all providers in zip 73601 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245742808 | Field & Forest Medical, LLC | General Practice | 18565 S Bandy Ln, Clinton, IN 47842-7334 | 2017-11-03 |
| 1144692393 | Complete Wellness and Integrative Health Center Ltd | General Practice | 211 E Quincy St, Clinton, IL 61727 | 2015-10-28 |
| 1154561389 | Altmed Medical Center Inc | General Practice | 8700 Old Branch Ave, Clinton, MD 20735-2522 | 2009-02-27 |
| 1316149727 | Martin A Schiefer | General Practice | 100 Cedar Cove Turtle Creek, Clinton, MS 39056-5428 | 2007-06-05 |
| 1790733855 | Agapito Fajardo | General Practice | 906 N Us 421 Hwy, Clinton, NC 28328-0410 | 2006-05-04 |
| 1851363535 | Vincent S Toussaint | General Practice | 103 Mississippi Drive, Clinton, SC 29325 | 2006-02-06 |
| 1235118837 | Betty A Hibler | General Practice | 1320 Main Ave, Clinton, IA 52732-1923 | 2006-01-11 |
| 1457347379 | Roger E Jones | General Practice | 819 S 3rd St, Clinton, IN 47842-2205 | 2005-09-26 |
| 1710365382 | Mary Annette Pugh Md, Pllc | General Practice | 2500 Highway 65 S, Clinton, AR 72031-6588 | 2015-05-14 |
| 1295133528 | Mgmc, LLC | General Practice | 8926 Woodyard Rd, Suite 602, Clinton, MD 20735-4220 | 2014-12-19 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.