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General NPI Number Information
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NPI Number | 1255752689
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Entity Type | Individual
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Provider Name | JOHN DELANO FORD DPH
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Gender | Male
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Dates
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Enumeration Date | 01/03/2014
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 7437 S OLYMPIA AVE
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City | TULSA
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State | OK
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Zip | 74132-1838
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Country | US
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Telephone | 918-254-1598
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Fax |
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Provider Business Mailing Address
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Address Line | 11104 E 66TH ST
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City | TULSA
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State | OK
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Zip | 74133-2605
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Country | US
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Telephone | 918-254-1598
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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 | 13183
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License Number State | OK
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