Provider Demographics
NPI:1487817656
Name:THOMPSON, DENNIS WAYNE (PHARMACIST)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:WAYNE
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 COPPERFIELD
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-2383
Mailing Address - Country:US
Mailing Address - Phone:405-372-3326
Mailing Address - Fax:
Practice Address - Street 1:2010 COPPERFIELD
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-2383
Practice Address - Country:US
Practice Address - Phone:405-372-3326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-08
Last Update Date:2008-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK8589OtherPHARMACY NUMBER-OKLAHOMA