Provider Demographics
NPI:1508974528
Name:WORK, STANLEY KEITH (PHARMD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:KEITH
Last Name:WORK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 4 BOX 190
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:OK
Mailing Address - Zip Code:73052-9148
Mailing Address - Country:US
Mailing Address - Phone:405-756-1556
Mailing Address - Fax:
Practice Address - Street 1:1515 NE LAWRIE TATUM RD
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73507-3002
Practice Address - Country:US
Practice Address - Phone:580-353-0350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist