National Provider Identifier
Russell Crockett Woglom, MD
Russell Crockett Woglom, MD is listed in the NPPES registry with a primary specialty of Internal Medicine Physician in Corning, NY and a listed phone number of (607) 936-9971.
Profile Overview
- NPI
- 1417923434
- Provider Type
- Individual
- Primary Specialty
- Internal Medicine Physician
- Enumeration Date
- February 28, 2006
- Last Updated
- March 03, 2021
Practice Location
- 130 Center Way
- Corning, NY 14830-2255
Phone: (607) 936-9971
Mailing Address
- 1 Guthrie Sq
- Sayre, PA 18840-1625
Specialties
- Internal Medicine Physician (207R00000X)
Endpoints
- rwoglom8370@direct-guthrie.org
Direct Messaging Address | Direct | Corning, NY 14830
Full Record
- NPI
- 1417923434
- Entity Type
- Individual
- Last Name
- Woglom
- First Name
- Russell
- Middle Name
- Crockett
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 1 Guthrie Sq
- Mailing City
- Sayre
- Mailing State
- PA
- Mailing ZIP Code
- 18840-1625
- Mailing Country
- US
- Mailing Phone
- (570) 888-5858
- Practice Street Address
- 130 Center Way
- Practice City
- Corning
- Practice State
- NY
- Practice ZIP Code
- 14830-2255
- Practice Country
- US
- Practice Phone
- (607) 936-9971
- Practice Fax
- (607) 936-2600
- Enumeration Date
- February 28, 2006
- Last Updated
- March 03, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- March 03, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Internal Medicine Physician (207R00000X)
- Other Identifiers
- 110224586 (NY, Rr Medicare Pin), CC8362 (NY, Rr Medicare Group), 01030271 (NY), 0010940660003 (PA)