| Russell Koch And Associates Inc | |
|
820 Wall St Norman OK 73069-6302 | |
| (405) 928-2044 | |
| (405) 928-2049 |
| Full Name | Russell Koch And Associates Inc |
|---|---|
| Speciality | Psychologist |
| Location | 820 Wall St, Norman, Oklahoma |
| Authorized Official Name and Position | Russell Eugene Koch (OWNER) |
| Authorized Official Contact | 4059282044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Russell Koch And Associates Inc 820 Wall St Norman OK 73069 Ph: (405) 928-2044 | Russell Koch And Associates Inc 820 Wall St Norman OK 73069-6302 Ph: (405) 928-2044 |
| NPI Number | 1043597446 |
|---|---|
| Provider Enumeration Date | 11/14/2011 |
| Last Update Date | 11/14/2011 |
| Medicare PECOS PAC ID | 6608038005 |
|---|---|
| Medicare Enrollment ID | O20120501000601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043597446 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 602 (Oklahoma) | Primary |
| Provider Name | Russell E Koch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275630410 PECOS PAC ID: 6406841410 Enrollment ID: I20040419001044 |
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