Provider Demographics
NPI:1003944331
Name:CAMPBELL, KATHY MAY (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:MAY
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 SOUTH DARLINGTON
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135
Mailing Address - Country:US
Mailing Address - Phone:918-836-1232
Mailing Address - Fax:
Practice Address - Street 1:130 S MAIN ST
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055
Practice Address - Country:US
Practice Address - Phone:918-274-1737
Practice Address - Fax:918-274-1745
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11371183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist