Individual
DR. RONALD WAYNE NICHOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
326 E CHEROKEE ST, WAGONER, OK 74467-4706
(918) 485-2317
(918) 485-8483
Mailing address
1106 SE 10TH ST, WAGONER, OK 74467-7218
(918) 485-3267
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7404
OK
Other
Enumeration date
10/18/2006
Last updated
06/23/2009
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