Individual
DR. JEROME JAY ERSLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH PHD
Contact information
Practice address
1300 NORTH 29TH STREET, CHICKASHA, OK 73018
(405) 224-0724
Mailing address
1300 NORTH 29TH STREET, CHICKASHA, OK 73018
(405) 224-0724
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
21539
TX
183500000X
Pharmacist
Primary
8996
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21539
STATE BD OF PHARMACY
TX
01
—
8996
STATE BD OF PHARMACY
OK
Enumeration date
05/10/2007
Last updated
07/08/2007
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