Clark, Gayle

Clark, Gayle is an individual health care provider with primary practice located at 815 E 6Th Street , Tishomingo OK 73460. She recently has only one registered license in Pharmacy Service Providers / Pharmacy Technician, which is considered as her primary health care specialty. Clark, Gayle can be contacted via phone (580) 371-2392.

Contact Information

Primary practice address
815 E 6Th Street Tishomingo OK 73460
Phone: (580) 371-2392
Fax: (580) 559-0610
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacy Technician 183700000X 6841 Oklahoma

Profile Details

NPI number 1679653570
LBN Legal business name Clark, Gayle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2006
Last updated Jul 20th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679653570 NPPES
Oklahoma Other 6841 OK LICENSE

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