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NPI Code Detail

MEDICARE: DR. KYLE T PANTER PHARMD

MEDICARE: DR. KYLE T PANTER PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11835P2201XAmbulatory Care Pharmacist12685OK

General Provider Information

NPI Number : 1467906412
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KYLE T PANTER PHARMD
Provider Business Mailing Address
First Line : 1704 S MAPLE AVE
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-6671
Country : US
Telephone Number : 918-258-1522
Fax Number :
Provider Business Practice Location Address
First Line : 510 N ELM PL
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-2539
Country : US
Telephone Number : 918-449-9988
Fax Number : 918-449-9989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2016
Last Update Date : 08/08/2016

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Directions to “ DR. KYLE T PANTER PHARMD” Practice Location

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