Provider Demographics
NPI:1558461053
Name:KARNS, BRUCE ALAN (DPH)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:ALAN
Last Name:KARNS
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 1:3113 BUCKINGHAM PL
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-3378
Mailing Address - Country:US
Mailing Address - Phone:405-354-1805
Mailing Address - Fax:
Practice Address - Street 1:235 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 1000
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-6624
Practice Address - Country:US
Practice Address - Phone:405-789-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12027183500000X, 1835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835N1003XPharmacy Service ProvidersPharmacistNutrition Support