Tony Haynie
Individual provider Active NPI Pharmacist · Marlow, OK
NPI 1497880868 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497880868
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 9864 (OK)
- Practice address
- RR 1 Box 245a
Marlow, OK 73055-6858 - Phone
- (580) 531-5858
- NPI assigned
- Feb 23, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9864 | OK | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 9864 | OK | Yes |
Addresses
Primary practice location
RR 1 Box 245a
Marlow, OK 73055-6858
Mailing address
RR 1 Box 245a
Marlow, OK 73055-6858
Other providers in Marlow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.