Provider Demographics
NPI:1770794000
Name:HEAD, BARBARA JO (PHARM TECH)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:JO
Last Name:HEAD
Suffix:
Gender:F
Credentials:PHARM TECH
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2120 W ELK AVE
Mailing Address - Street 2:SUITE 10
Mailing Address - City:DUNCAN
Mailing Address - State:OK
Mailing Address - Zip Code:73533-1500
Mailing Address - Country:US
Mailing Address - Phone:580-255-7165
Mailing Address - Fax:580-255-0720
Practice Address - Street 1:2120 W ELK AVE
Practice Address - Street 2:SUITE 10
Practice Address - City:DUNCAN
Practice Address - State:OK
Practice Address - Zip Code:73533-1500
Practice Address - Country:US
Practice Address - Phone:580-255-7165
Practice Address - Fax:580-255-0720
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKT2507183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician