Individual
OLIVER GARY LACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D
Contact information
Practice address
624 N MAIN ST, FAIRVIEW, OK 73737
(580) 227-4000
(580) 227-4003
Mailing address
624 N MAIN ST, FAIRVIEW, OK 73737-1216
(580) 227-4000
(580) 227-4003
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14245
OK
Other
Enumeration date
11/14/2011
Last updated
06/12/2019
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