Healthcare Provider Details
I. General information
NPI: 1265594899
Provider Name (Legal Business Name): NEWTON TRUETT GUTHRIE DPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/13/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 W 4TH ST
HOBART OK
73651-4010
US
IV. Provider business mailing address
732 N STADIUM DR
HOBART OK
73651-2014
US
V. Phone/Fax
- Phone: 580-726-2221
- Fax:
- Phone: 580-726-2221
- Fax: 580-726-3530
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | 8106 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: