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Individual

JEFFERY COLE CATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPH

Contact information

Practice address
781 GRAND CASINO BLVD, SHAWNEE, OK 74804-1005
(405) 964-5770
Mailing address
2508 NW 25TH ST, OKLAHOMA CITY, OK 73107-2206
(405) 943-9412

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9500
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
9500
OKLAHOMA STATE BOARD OF PHARMACY
OK
Enumeration date
07/20/2011
Last updated
07/20/2011
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