Individual
DR. JEREMY MARK BENNIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
115 W 3RD ST, ELK CITY, OK 73644-4721
(580) 225-4418
(580) 225-4415
Mailing address
115 W 3RD ST, ELK CITY, OK 73644-4721
(580) 225-4418
(580) 225-4415
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13725
OK
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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