Provider Demographics
NPI:1053669333
Name:KIRKPATRICK, ALICE E
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:E
Last Name:KIRKPATRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:E
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:4502 E 41ST ST
Mailing Address - Street 2:SUITE 1H23
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2536
Mailing Address - Country:US
Mailing Address - Phone:918-660-3585
Mailing Address - Fax:918-660-3580
Practice Address - Street 1:4502 E 41ST ST
Practice Address - Street 2:SUITE 1H23
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2536
Practice Address - Country:US
Practice Address - Phone:918-660-3585
Practice Address - Fax:918-660-3580
Is Sole Proprietor?:No
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11181183500000X
NC9238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist