Clifford Blaine Polk

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

10516 Issued in OK

Practice address

420 E Jackson St
Hugo, OK 74743-4021

Phone

(580) 326-8337

Fax

(580) 326-8338

NPI assigned

Oct 21, 2019

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hugo Family Pharmacy

  • Community/Retail Pharmacy
  • Hugo, OK
  • NPI 1962837039
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571616000000",
    "number": "1174166300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E JACKSON ST",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "747434021",
            "telephone_number": "580-326-8337",
            "fax_number": "580-326-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E JACKSON ST",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "747434021",
            "telephone_number": "580-326-8337",
            "fax_number": "580-326-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLK",
        "first_name": "CLIFFORD",
        "middle_name": "BLAINE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-21",
        "last_updated": "2019-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "OK",
            "license": "10516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendall Phillips, FNP
• Physical Therapy Clinic of Paris LP
• Elizabeth Pierce
• Sara Ruth Pierce, LMSW
• Jacqueline Kit Pipkin, B.S.
• Malinda Gail Pollard, M.S., CCC-SLP
• Providence of Oklahoma
• Providence Service Corp
• Providence Service Corporation of Oklahoma
• Providence Service Corporation of Oklahoma

• Ambulatory Care Pharmacist in Hugo, OK
• Providers in Hugo, OK by specialty
• Ambulatory Care Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.