Provider Demographics
NPI:1265918460
Name:CURRY, RANDY GLEN (DPH)
Entity type:Individual
Prefix:
First Name:RANDY
Middle Name:GLEN
Last Name:CURRY
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2025
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-8025
Mailing Address - Country:US
Mailing Address - Phone:918-290-9224
Mailing Address - Fax:
Practice Address - Street 1:615 OAK DR
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-4209
Practice Address - Country:US
Practice Address - Phone:918-290-9224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-11
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9362183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist