Healthcare Provider Details

I. General information

NPI: 1578490249
Provider Name (Legal Business Name): LYNSEY POPP PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 S MAIN ST
GROVE OK
74344-5327
US

IV. Provider business mailing address

2115 S MAIN ST
GROVE OK
74344-5327
US

V. Phone/Fax

Practice location:
  • Phone: 918-786-4491
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21313
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: