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Individual

DR. DERRICK JONES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
310 FAIRVIEW AVE, PONCA CITY, OK 74601-2001
(580) 762-6335
(580) 762-4210
Mailing address
310 FAIRVIEW AVE, PONCA CITY, OK 74601-2001
(580) 762-6335
(580) 762-4210

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13409
OK

Other

Enumeration date
09/10/2010
Last updated
09/10/2010
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