| Doctor Name: | DR. RUSSELL JOHN GREEN |
| NPI Number: | 1003928532 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 17587 |
| Business Practice Address: | 8751 N 117th East Ave Unit H Owasso, OK - 740552098 |
| Business Phone Number: | 9186091600 |
| Business Fax Number: | 9186091319 |
| Mailing Address: | 8751 N 117th East Ave, Unit H OWASSO |
| State: | OK |
| Postal Code: | 740552098 |
| Phone Number: | 9186091600 |
| Fax Number: | 9186091319 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 07/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2083P0500X |
| License Number: | 17587 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Preventive Medicine |
| Taxonomy Specialization: | Preventive Medicine/Occupational Environmental Medicine |
| Taxonomy Definition: | A preventive medicine physician who specializes in preventive medicine/occupational-environmental medicine, which is focused on protecting the population from occupational and environmental conditions. |