Provider Demographics
NPI:1831961416
Name:CALLOWAY, TANNER JAMES (PHARMACIST)
Entity type:Individual
Prefix:
First Name:TANNER
Middle Name:JAMES
Last Name:CALLOWAY
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N PORTER AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6426
Mailing Address - Country:US
Mailing Address - Phone:405-364-5222
Mailing Address - Fax:
Practice Address - Street 1:900 N PORTER AVE STE 101
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6426
Practice Address - Country:US
Practice Address - Phone:405-364-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist