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Individual

MR. CHRIS L JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPH

Contact information

Practice address
1213 N GLENN ENGLISH ST, CORDELL, OK 73632-2009
(580) 832-3714
Mailing address
1213 N GLENN ENGLISH ST, CORDELL, OK 73632-2009
(580) 832-3714

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12412
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200608360A
OK
01
33-7414
OK STATE BOARD OF PHARMACY
OK
01
3729021
NCPDP
OK
Enumeration date
08/09/2006
Last updated
03/07/2023
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