=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386978740
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATHERINE RENE DOSSEY D.PH.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/01/2009
-----------------------------------------------------
Last Update Date | 10/01/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8054 HWY 16 #100
-----------------------------------------------------
City | BEGGS
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74421
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-267-4890
-----------------------------------------------------
Fax | 918-267-4061
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 36
-----------------------------------------------------
City | BEGGS
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74421-0036
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-267-4890
-----------------------------------------------------
Fax | 918-267-4061
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 10322
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------