Provider Demographics
NPI:1760768758
Name:HARRISON, CHRIS MICHAEL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:MICHAEL
Last Name:HARRISON
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 1:17608 LEAD LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-6959
Mailing Address - Country:US
Mailing Address - Phone:405-473-1709
Mailing Address - Fax:
Practice Address - Street 1:2100 W BRITTON RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-1506
Practice Address - Country:US
Practice Address - Phone:405-842-0745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-23
Last Update Date:2011-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15053183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist