Individual
BENJAMIN RUSSELL WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
100 N J M DAVIS BLVD, CLAREMORE, OK 74017-6811
(918) 341-4938
Mailing address
9700 E 108TH ST N, OWASSO, OK 74055-7238
(918) 527-2396
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
15328
OK
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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