Provider Demographics
NPI:1225462872
Name:BURKLE, JEFF (PHARM D)
Entity Type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:BURKLE
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4016 S HIGHWAY 97
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-3812
Mailing Address - Country:US
Mailing Address - Phone:918-245-6661
Mailing Address - Fax:918-245-4843
Practice Address - Street 1:4016 S HIGHWAY 97
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-3812
Practice Address - Country:US
Practice Address - Phone:918-245-6661
Practice Address - Fax:918-245-4843
Is Sole Proprietor?:No
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist