Provider Demographics
NPI:1285645598
Name:SPOON, JAMES OWEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:OWEN
Last Name:SPOON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1325 N OLD NORTH PL
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-8985
Mailing Address - Country:US
Mailing Address - Phone:918-245-1830
Mailing Address - Fax:918-245-1693
Practice Address - Street 1:3404 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-8016
Practice Address - Country:US
Practice Address - Phone:918-743-6623
Practice Address - Fax:918-743-6654
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8768183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist