Individual
MR. CLINTON D BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH, NCPS
Contact information
Practice address
1 CHOCTAW WAY, TALIHINA, OK 74571-2022
(918) 567-7000
(918) 567-7134
Mailing address
1 CHOCTAW WAY, TALIHINA, OK 74571-2022
(918) 567-7000
(918) 567-7134
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15401
OK
1835P1200X
Pharmacotherapy Pharmacist
043592
MO
Other
Enumeration date
05/24/2005
Last updated
12/03/2018
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