Individual
DONOVAN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1117 W I 35 FRONTAGE RD, EDMOND, OK 73034-7398
(405) 757-3802
(405) 757-3251
Mailing address
1117 W I 35 FRONTAGE RD, EDMOND, OK 73034-7398
(405) 757-3802
(405) 757-3251
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14472
OK
183500000X
Pharmacist
PD12183
AR
Other
Enumeration date
10/27/2020
Last updated
04/30/2024
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