Kyle Clark, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

16110 Issued in OK

Practice address

401 Linwood PLZ
Lindsay, OK 73052-4602

Phone

(405) 756-9591

NPI assigned

Oct 28, 2020

Last updated

Oct 28, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Credentials

Doctor of Pharmacy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wal-Mart Stores East LP

  dba Walmart Pharmacy 10-0893

  • Community/Retail Pharmacy
  • Lindsay, OK
  • NPI 1952328072
  NPD (past)
• Wal-Mart Stores East, LP

  dba Walmart Pharmacy 10-2229

  • Pharmacy
  • Apollo Beach, FL
  • NPI 1437027208
  NPD (past)

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1922608926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 LINWOOD PLZ",
            "city": "LINDSAY",
            "state": "OK",
            "postal_code": "730524602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 LINWOOD PLZ",
            "city": "LINDSAY",
            "state": "OK",
            "postal_code": "730524602",
            "telephone_number": "405-756-9591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 N Porter Ave",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730716404",
            "country_code": "US",
            "telephone_number": "405-307-1940",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-28",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "16110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norma Jean Beard, MA
• Michael Boeckman, O.D.
• Bounds Family Clinic Inc.
• Timothy Braun, PA-C
• City of Lindsay (EMS)
• Colorectal Specialists PC
• Complete Family Wellness and Urgent Care
• Sue Ann Dutton, DPH
• Don Keith Ferguson, MD
• Novyce V Ferguson, APRN

• Pharmacist in Lindsay, OK
• Providers in Lindsay, OK by specialty
• Pharmacist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.