Provider Demographics
NPI:1952513087
Name:FOSTER, BRAD DOUGLAS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:DOUGLAS
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3209 RIDGE VIEW LANE
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:OK
Mailing Address - Zip Code:73010
Mailing Address - Country:US
Mailing Address - Phone:405-517-1751
Mailing Address - Fax:405-485-4284
Practice Address - Street 1:901 N PORTER
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73070-1308
Practice Address - Country:US
Practice Address - Phone:405-307-1951
Practice Address - Fax:405-307-1948
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK133361835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy