Individual
AUSTIN WAYNE CRISSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D, MBA, BCPS
Contact information
Practice address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
(580) 220-6704
Mailing address
1011 14TH AVE NW, ARDMORE, OK 73401-1828
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
18919
OK
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/19/2019
Last updated
03/17/2026
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