Provider Demographics
NPI:1578843108
Name:RAMPLEY, WAYNE ALLAN
Entity Type:Individual
Prefix:
First Name:WAYNE
Middle Name:ALLAN
Last Name:RAMPLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3208 PHOENIX DR
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-6203
Mailing Address - Country:US
Mailing Address - Phone:918-869-2912
Mailing Address - Fax:
Practice Address - Street 1:100 N 32ND ST
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74401-2101
Practice Address - Country:US
Practice Address - Phone:918-687-1319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9676183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist