Individual
KEVIN TODD ROADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3401 N MAY AVE STE B, OKLAHOMA CITY, OK 73112-6953
(405) 843-6691
(405) 848-3591
Mailing address
1202 WHISPERING RIDGE DR, TUTTLE, OK 73089-8607
(405) 834-4265
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12215
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100232840A
—
OK
05
—
100232840B
—
OK
Enumeration date
07/14/2022
Last updated
07/14/2022
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