NPI 1073041299

Russell Wayne Jefferson, DO

Practitioner General Practice Physician Clinton, OK

Practice location

Address: 501 S 11th St, Clinton, OK 73601-4303
Phone: (580) 819-0082

Registered specialties (2)

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 6428 (OK)

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Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1073041299
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Jun 2017
Record last updated: 21 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.