Jack Russelle Lake D.O.

  • 1932248101 NPI Number
  • |
  • Actived: 12 years ago
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According to our database, NPI number for Jack Russelle Lake D.O. is 1932248101 and actived since Monday, February 5 2007. Jack Russelle Lake D.O. is an individual provider specializes in Diagnostic Radiology, primary practice location is 940 Ne 13th St, Oklahoma City, OK 73104. You can also contact Jack Russelle Lake D.O. via telephone number is (405) 271-5125. Provider NPI information was last updated on 01/26/2011.

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Overview of Jack Russelle Lake D.O.

  • NPI number: 1912540212
  • Provider type: Individual
  • Specialty: Diagnostic Radiology
  • Gender: Male
  • Active since: 02/05/2007
  • Last updated: 01/26/2011

Primary Scrop of Practice

  • Taxonomy Code: 2085R0202X
  • Specialty: Diagnostic Radiology
  • License Number: 4205
  • License State: OK

Provider Mailing Address

  • Address: 940 Ne 13th St
    4g4250
    Oklahoma City, OK 73104
  • Phone:
  • Fax:

Provider Practice Location

  • Address: 940 Ne 13th St
    4g4250
    Oklahoma City, OK 73104
  • Phone: 405-271-5125
  • Fax: 405-271-3462

Scope of Practice

  • Taxonomy Code: 2085R0202X
  • Specialty: Diagnostic Radiology
  • License Number: 4205
  • License State: OK
  • Switch: Yes

Question & Answers

What is the npi number?

  • Q: What is the npi number for Jack Russelle Lake D.O.?
  • A: The npi number for Jack Russelle Lake D.O. is 1932248101.
  • Q: What are Jack Russelle Lake D.O.'s specialties?
  • A: Jack Russelle Lake D.O.'s specialties are Diagnostic Radiology and different specialities.
  • Q: What is the medical license for Jack Russelle Lake D.O.?
  • A: The medical license number for Jack Russelle Lake D.O. is 4205 and issued in OK in USA.
  • Q: Where is Jack Russelle Lake D.O. practice location?
  • A: Jack Russelle Lake D.O. is practicing at 940 Ne 13th St, Oklahoma City, OK 73104.
  • Q: How to contact Jack Russelle Lake D.O.?
  • A: You can contact Jack Russelle Lake D.O. via 405-271-5125.