Healthcare Provider Details

I. General information

NPI: 1679493779
Provider Name (Legal Business Name): COLTON HARPER PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 W BROADWAY ST
SPIRO OK
74959-2419
US

IV. Provider business mailing address

2008 E BROADWAY ST
SPIRO OK
74959-3046
US

V. Phone/Fax

Practice location:
  • Phone: 918-962-2131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19812
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: