Provider Demographics
NPI:1831125764
Name:PIOWATY, KRISTI S (DPH)
Entity type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:S
Last Name:PIOWATY
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:S
Other - Last Name:PRESLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:MOUNDS
Mailing Address - State:OK
Mailing Address - Zip Code:74047-0032
Mailing Address - Country:US
Mailing Address - Phone:918-827-6301
Mailing Address - Fax:918-827-6296
Practice Address - Street 1:1419 COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:MOUNDS
Practice Address - State:OK
Practice Address - Zip Code:74047-0032
Practice Address - Country:US
Practice Address - Phone:918-827-6301
Practice Address - Fax:918-827-6296
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11321183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK0859530001Medicare ID - Type Unspecified
OK0859530001Medicare NSC