Individual
JARRYD MATHEWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
328 N 6TH ST, PERRY, OK 73077-6607
(580) 336-2136
Mailing address
328 N 6TH ST, PERRY, OK 73077-6607
(580) 336-2136
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15993
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R15993
OKLAHOMA STATE BOARD OF PHARMACY
OK
Enumeration date
12/22/2020
Last updated
12/22/2020
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