HOLDER, RUSSELL - Licensee Information

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Last Update: Sunday, May 5, 2024 4:03 AM CDT
Next Update: Sunday, May 5, 2024 12:00 PM CDT

HOLDER, RUSSELL

Practice Address:	UTICA PARK CLINIC MUSKOGEE 615 S 32ND ST MUSKOGEE OK 74401 Address last updated on 4/16/2024
Phone #:	(539) 239-5249
Fax #:
County:	MUSKOGEE
License:	4945
Dated:	1/5/2023
Expires:	3/31/2025
License Type:	Physician Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2025

Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.

All information below is entered by the licensee but not verified by the Oklahoma Medical Board.

Locations:	Hours:	Languages:
UTICA PARK CLINIC MUSKOGEE 615 S 32ND ST MUSKOGEE OK 74401 Phone #: (539) 239-5249 Fax #:

Hospital Privileges:

None listed

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
ROBERT LEE VALENTINE	MD	27774

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Oklahoma State Board of Medical Licensure and Supervision :: 101 NE 51st St, Oklahoma City, OK 73105-1821
Main Number: (405) 962-1400 :: Fax: (405) 962-1440 :: Complaints outside 405 area code: 1-800-381-4519
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