Provider Demographics
NPI:1316184450
Name:JONES, RUSSELL PAUL (RCP)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:PAUL
Last Name:JONES
Suffix:
Gender:M
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74401-4451
Mailing Address - Country:US
Mailing Address - Phone:918-686-0218
Mailing Address - Fax:918-686-0345
Practice Address - Street 1:1601 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-4451
Practice Address - Country:US
Practice Address - Phone:918-686-0218
Practice Address - Fax:918-686-0345
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2009-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK754227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified