Provider Demographics
NPI:1376743286
Name:REECE, LANCE (DPH)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:
Last Name:REECE
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 S WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4224
Mailing Address - Country:US
Mailing Address - Phone:405-624-3535
Mailing Address - Fax:405-624-3536
Practice Address - Street 1:723 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4224
Practice Address - Country:US
Practice Address - Phone:405-624-3535
Practice Address - Fax:405-624-3536
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist