Individual
EDWARD HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
921 NE 13TH ST, OKLAHOMA CITY, OK 73104-5007
(405) 270-0501
Mailing address
1536 SW 81ST ST, OKLAHOMA CITY, OK 73159-5310
(405) 681-2350
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9720
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9720
PHARMACIST LICENSE
OK
Enumeration date
10/25/2006
Last updated
07/08/2007
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