Individual
TYLER CHRISTIAN DECKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4400 GRANT BLVD STE 101, YUKON, OK 73099-0038
(405) 577-6775
(844) 908-1423
Mailing address
4400 GRANT BLVD STE 101, YUKON, OK 73099-0038
(405) 577-6775
(844) 908-1423
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15690
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200925650A
—
OK
Enumeration date
02/08/2021
Last updated
02/08/2021
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