Individual
JAYSON MIKEL FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3105
(918) 458-3508
Mailing address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3105
(918) 458-3508
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14512
OK
Other
Enumeration date
12/06/2010
Last updated
12/06/2010
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