Provider Demographics
NPI:1568800084
Name:DOUGLAS, VICTORIA DAWN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:DAWN
Last Name:DOUGLAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:OK
Mailing Address - Zip Code:74016-2030
Mailing Address - Country:US
Mailing Address - Phone:918-789-2241
Mailing Address - Fax:918-789-3705
Practice Address - Street 1:600 WALNUT ST
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:OK
Practice Address - Zip Code:74016-2030
Practice Address - Country:US
Practice Address - Phone:918-789-2241
Practice Address - Fax:918-789-3705
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13320183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy