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Individual

MR. RICHARD EUGENE DORL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPH

Contact information

Practice address
328 N 6TH ST, PERRY, OK 73077-6607
(580) 336-2136
(580) 336-9445
Mailing address
5708 EAST GLENCOE ROAD, GLENCOE, OK 74032
(580) 669-1112

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10453
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10453
STATE LICENSE
OK
Enumeration date
09/20/2006
Last updated
04/20/2019
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