Individual
STEVEN RANDOLPH MATLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
7128 EAST RENO AVENUE, SUITE A, MIDWEST CITY, OK 73110
(405) 737-3464
(405) 737-9554
Mailing address
12008 RIVENDELL DRIVE, OKLAHOMA CITY, OK 73170
(405) 691-7270
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9146
OK
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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