Provider Demographics
NPI:1508116542
Name:JONES, KATHRYN DEAN (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:DEAN
Last Name:JONES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MRS
Other - First Name:KATY
Other - Middle Name:DEAN
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARM D
Mailing Address - Street 1:105365 SOUTH HIGHWAY 102
Mailing Address - Street 2:
Mailing Address - City:MCLOUD
Mailing Address - State:OK
Mailing Address - Zip Code:74851
Mailing Address - Country:US
Mailing Address - Phone:405-964-2081
Mailing Address - Fax:405-964-5968
Practice Address - Street 1:105365 SOUTH HIGHWAY 102
Practice Address - Street 2:
Practice Address - City:MCLOUD
Practice Address - State:OK
Practice Address - Zip Code:74851
Practice Address - Country:US
Practice Address - Phone:405-964-2081
Practice Address - Fax:405-964-5968
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15214183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist