Provider Demographics
NPI:1417559139
Name:TIPTON, ASHLEY (RPH)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:TIPTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4900 S SOONER RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73135-5428
Mailing Address - Country:US
Mailing Address - Phone:405-458-6260
Mailing Address - Fax:
Practice Address - Street 1:4900 S SOONER RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73135-5428
Practice Address - Country:US
Practice Address - Phone:405-458-6260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist