Individual
BENJAMIN JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
268 S 7TH ST, VINITA, OK 74301-3737
(918) 256-6435
Mailing address
1337 S WINSTON AVE, TULSA, OK 74112-6142
(918) 766-6550
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18483
OK
Other
Enumeration date
11/01/2020
Last updated
11/01/2020
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