Individual
RICKY E BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12515 E 55TH ST STE 101, TULSA, OK 74146-6234
(918) 493-2727
(800) 375-2729
Mailing address
12515 E 55TH ST STE 101, TULSA, OK 74146-6234
(918) 493-2727
(800) 375-2729
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15155
OK
Other
Enumeration date
12/21/2018
Last updated
12/21/2018
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