Individual
PHILLIP ANDREW MICHAEL CUPPLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2415 N MAIN ST, MIAMI, OK 74354-2232
(918) 542-8429
(915) 542-8420
Mailing address
3801 S 199TH EAST AVE, BROKEN ARROW, OK 74014-1390
(918) 932-5896
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17407
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17407
PHARMACIST LICENSE
OK
Enumeration date
07/10/2020
Last updated
07/10/2020
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