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Individual

JERRY DAVID FRASER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.PH.

Contact information

Practice address
1101 HONOR HEIGHTS DR, PHARMACY DEPARTMENT, MUSKOGEE, OK 74401-1302
(918) 577-3185
(918) 577-4463
Mailing address
1101 HONOR HEIGHTS DR, PHARMACY DEPARTMENT, MUSKOGEE, OK 74401-1302
(918) 577-3185
(918) 577-4463

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
9765
OK

Other

Enumeration date
01/08/2013
Last updated
01/08/2013
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