Provider Demographics
NPI:1912070665
Name:PROCTOR, FRANCIS GILBERT (DPH)
Entity Type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:GILBERT
Last Name:PROCTOR
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 1:8425 SHADYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74131-3881
Mailing Address - Country:US
Mailing Address - Phone:918-224-4912
Mailing Address - Fax:
Practice Address - Street 1:1001 E DEWEY AVE
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-4558
Practice Address - Country:US
Practice Address - Phone:918-224-2704
Practice Address - Fax:918-224-2713
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11-4040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist