Individual
KELLY RAY EARHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
305 S 5TH ST, ENID, OK 73701-5832
(580) 249-3062
(580) 249-3736
Mailing address
4529 S COVERED WAGON TRL, ENID, OK 73701-8546
(580) 977-7153
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13003
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13003
PHARMACIST
OK
Enumeration date
09/04/2020
Last updated
09/04/2020
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