Healthcare Provider Details

I. General information

NPI: 1174700355
Provider Name (Legal Business Name): LINDSAY DALLAS GATRELL PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 KIHEKAH AVE
PAWHUSKA OK
74056-3206
US

IV. Provider business mailing address

714 KIHEKAH AVE
PAWHUSKA OK
74056-3206
US

V. Phone/Fax

Practice location:
  • Phone: 918-287-1317
  • Fax: 918-287-1158
Mailing address:
  • Phone: 918-287-1317
  • Fax: 918-287-1158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number14136
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberR-14136
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: