Provider Demographics
NPI:1023440849
Name:GUINUP, MARK RAYMOND JR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:RAYMOND
Last Name:GUINUP
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2030 NW 82ND ST
Mailing Address - Street 2:T-2739
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-2355
Mailing Address - Country:US
Mailing Address - Phone:580-354-7275
Mailing Address - Fax:580-354-7285
Practice Address - Street 1:2030 NW 82ND ST
Practice Address - Street 2:T-2739
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-2355
Practice Address - Country:US
Practice Address - Phone:580-354-7275
Practice Address - Fax:580-354-7285
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK15461183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist