Individual
MARCUS TAD AUTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D., BCPS
Contact information
Practice address
900 NE 10TH ST, OKLAHOMA CITY, OK 73104-5420
(405) 271-2900
Mailing address
480 ELM AVE, NORMAN, OK 73069-5712
(918) 809-8526
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
17001
OK
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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