Provider Demographics
NPI:1093570186
Name:GLADD, CALEB ROSS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CALEB
Middle Name:ROSS
Last Name:GLADD
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 1:2107 NW CACHE RD
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-5213
Mailing Address - Country:US
Mailing Address - Phone:580-353-1588
Mailing Address - Fax:580-353-1856
Practice Address - Street 1:2107 NW CACHE RD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-5213
Practice Address - Country:US
Practice Address - Phone:580-353-1588
Practice Address - Fax:580-353-1856
Is Sole Proprietor?:No
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14390183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist