Provider Demographics
NPI:1780911230
Name:SKINNER, RODNEY ALLEN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:ALLEN
Last Name:SKINNER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ELK CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73644-4751
Mailing Address - Country:US
Mailing Address - Phone:580-225-2121
Mailing Address - Fax:580-225-4216
Practice Address - Street 1:105 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-4751
Practice Address - Country:US
Practice Address - Phone:580-225-2121
Practice Address - Fax:580-225-4216
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14305183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist