Provider Demographics
NPI:1821699927
Name:GABLE, MACHELL LYN (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:
First Name:MACHELL
Middle Name:LYN
Last Name:GABLE
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 BUSHEYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-9762
Mailing Address - Country:US
Mailing Address - Phone:405-887-8762
Mailing Address - Fax:
Practice Address - Street 1:951 E SH 152
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064-5119
Practice Address - Country:US
Practice Address - Phone:405-376-4525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11869183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist