Provider Demographics
NPI:1043628241
Name:ARNOLD, BRANDON (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 17TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-3009
Mailing Address - Country:US
Mailing Address - Phone:580-256-5586
Mailing Address - Fax:580-256-7574
Practice Address - Street 1:1003 17TH ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-3009
Practice Address - Country:US
Practice Address - Phone:580-256-5586
Practice Address - Fax:580-256-7574
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14014183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist