Individual
ELMER GENE HUMPHREYS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D.
Contact information
Practice address
45 ALMOND DR, ARDMORE, OK 73401-2405
(405) 301-7681
Mailing address
45 ALMOND DR, ARDMORE, OK 73401-2405
(405) 301-7681
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17975
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200862840A
—
OK
Enumeration date
03/01/2021
Last updated
03/01/2021
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