MEDICARE: DR. TREVOR SIPES

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
1	183500000X	Pharmacist	13445	OK

General Provider Information

NPI Number	:	1831506245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TREVOR SIPES

Provider Business Mailing Address
First Line	:	1400 24TH AVE NW
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73069-6385
Country	:	US
Telephone Number	:	405-235-3001
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 24TH AVE NW
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73069-6385
Country	:	US
Telephone Number	:	405-235-3001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	07/17/2014

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Directions to “ DR. TREVOR SIPES ” Practice Location

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