Provider Demographics
NPI:1164808044
Name:MCDANIEL, CHAD ROBERT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:ROBERT
Last Name:MCDANIEL
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 1:2311 W WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-2433
Mailing Address - Country:US
Mailing Address - Phone:580-234-7700
Mailing Address - Fax:580-234-7731
Practice Address - Street 1:2311 W WILLOW RD
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-2433
Practice Address - Country:US
Practice Address - Phone:580-234-7700
Practice Address - Fax:580-234-7731
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2020-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15487183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist