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General NPI Number Information
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NPI Number | 1346128147
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Entity Type | Individual
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Provider Name | DWIGHT FORBIS
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Gender | Male
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 817 E 6TH ST
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City | TISHOMINGO
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State | OK
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Zip | 73460-1800
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Country | US
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Telephone | 580-371-2361
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Fax |
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Provider Business Mailing Address
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Address Line | 1618 TREATY RD
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City | CALERA
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State | OK
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Zip | 74730-4522
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Country | US
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Telephone | 580-980-9999
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Fax | 580-371-3313
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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 | 20036
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License Number State | OK
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