Provider Demographics
NPI:1346717063
Name:PILKINGTON, CARLA KAY (DPH)
Entity Type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:KAY
Last Name:PILKINGTON
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1329 SOUTH MAIN ST
Mailing Address - Street 2:UNIT C
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066
Mailing Address - Country:US
Mailing Address - Phone:918-512-6635
Mailing Address - Fax:918-512-6638
Practice Address - Street 1:1329 SOUTH MAIN ST
Practice Address - Street 2:UNIT C
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066
Practice Address - Country:US
Practice Address - Phone:918-512-6635
Practice Address - Fax:918-512-6638
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9973183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist