Provider Demographics
NPI:1013297746
Name:FLICKINGER, ABBIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ABBIE
Middle Name:
Last Name:FLICKINGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ABBIE
Other - Middle Name:
Other - Last Name:ACKERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:110 OAKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROLAND
Mailing Address - State:OK
Mailing Address - Zip Code:74954-3000
Mailing Address - Country:US
Mailing Address - Phone:479-629-8779
Mailing Address - Fax:
Practice Address - Street 1:2701 ROGERS AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-4225
Practice Address - Country:US
Practice Address - Phone:497-783-4782
Practice Address - Fax:479-783-7092
Is Sole Proprietor?:No
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR10926183500000X
OK14413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist