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General NPI Number Information
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NPI Number | 1083741383
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Entity Type | Individual
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Provider Name | TROY SIMONS
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Gender | Male
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 02/25/2013
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Provider Practice Location Address
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Address Line | 328 N 6TH ST
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City | PERRY
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State | OK
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Zip | 73077-6607
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Country | US
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Telephone | 580-336-2136
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Fax | 580-336-9445
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Provider Business Mailing Address
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Address Line | 616 N ROCK CT
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City | STILLWATER
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State | OK
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Zip | 74075-8817
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Country | US
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Telephone | 405-372-4882
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12299
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License Number State | OK
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