Individual
DR. JOHNATHAN GREGORY HEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2001 S 1ST ST, CHICKASHA, OK 73018-6007
(405) 224-0292
Mailing address
2001 S 1ST ST, CHICKASHA, OK 73018-6007
(405) 224-0292
(405) 224-0296
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18866
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18866
STATE LICENSE
OK
Enumeration date
10/28/2020
Last updated
10/28/2020
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