Phillip G Russell (NPI# 1659353480, PAC ID# 9032136452) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
Nation Provider ID (NPI) | 1659353480 |
PAC ID by PECOS | 9032136452 |
Professional Enrollment ID | I20051026000648 |
Full Name | Phillip G Russell |
Organization Legal Name | STILLWATER RADIOLOGY LLC |
Address |
4721 W 6th Ave Suite 130 Stillwater OK 74074-1549 |
Phone Number | 4057430550 |
Gender | M |
Credential | MD |
Medical School | UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE |
Graduation Year | 1978 |
Primary Specialty | DIAGNOSTIC RADIOLOGY |
Group Practice PAC ID | 1153348578 |
Number of Group Practice Members | 3 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
370049 | STILLWATER MEDICAL CENTER |
370030 | BLACKWELL REGIONAL HOSPITAL |
Address | Phone | Organization |
---|---|---|
4721 W 6th Ave, Suite 130, Stillwater, OK 74074-1549 | 4057430550 | STILLWATER RADIOLOGY LLC |
Organization Legal Name | STILLWATER RADIOLOGY LLC |
Physicians | 3 |
Name | Specialty | Organization | Address |
---|---|---|---|
Charles R Horner Jr. | Diagnostic Radiology | Stillwater Radiology LLC | 4721 W 6th Ave, Suite 130, Stillwater, OK 74074-1549 |
Brandon R Mason | Diagnostic Radiology | Stillwater Radiology LLC | 4721 W 6th Ave, Suite 130, Stillwater, OK 74074-1549 |
Street Address |
4721 W 6TH AVE SUITE 130 |
City | STILLWATER |
State | OK |
Zip | 74074-1549 |
Name | Specialty | Organization | Address |
---|---|---|---|
Charles R Horner Jr. | Diagnostic Radiology | Stillwater Radiology LLC | 4721 W 6th Ave, Suite 130, Stillwater, OK 74074-1549 |
Brandon R Mason | Diagnostic Radiology | Stillwater Radiology LLC | 4721 W 6th Ave, Suite 130, Stillwater, OK 74074-1549 |
Name | Specialty | Organization | Address |
---|---|---|---|
Kenda G Baker | Physician Assistant | Oliver Street 5.01(a) Inc. | 1329 S Sangre Rd, Us Dermatology Partners, Stillwater, OK 74074-1854 |
Thomas C Hall | Dermatology | Oliver Street 5.01(a) Inc. | 1329 S Sangre Rd, Us Dermatology Partners, Stillwater, OK 74074-1854 |
Deanna J Cummings | Physician Assistant | Oliver Street 5.01(a) Inc. | 1329 S Sangre Rd, Us Dermatology Partners, Stillwater, OK 74074-1854 |
Sara K Metcalf | Dermatology | Oliver Street 5.01(a) Inc. | 1329 S Sangre Rd, Us Dermatology Partners, Stillwater, OK 74074-1854 |
J Weston H. Reese | Chiropractic | Reese Chiropractic and Wellness, P.C. | 1505 S Sangre Rd, Stillwater, OK 74074-1869 |
Ashton Nicole Shelton | Chiropractic | Reese Chiropractic and Wellness, P.C. | 1505 S Sangre Rd, Stillwater, OK 74074-1869 |
Jennifer Pauline Childers | Clinical Social Worker | Jennifer Childers Lcsw Counseling LLC | 2324 W 7th Pl, Stillwater, OK 74074-1927 |
Catherine Kindt | Nurse Practitioner | Stillwater Medical Center Authority | 1815 W 6th Ave, Stillwater Med C Clinic W, Stillwater, OK 74074-2402 |
Terry N Brown | Internal Medicine | Stillwater Medical Center Authority | 1815 W 6th Ave, Stillwater Med C Clinic W, Stillwater, OK 74074-2402 |
Melissa Shanay Herring | Family Medicine | Stillwater Medical Center Authority | 1815 W 6th Ave, Stillwater Med C Clinic W, Stillwater, OK 74074-2402 |
Find all physicians in zip 74074 |
City | STILLWATER |
Zip Code | 74074 |
Specialty | DIAGNOSTIC RADIOLOGY |
City + Specialty | STILLWATER + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Phillip G Russell.
Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.