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NPI 1629156328

NPI 1629156328 : HERMAN BOYD STEPHENS DPH : TULSA, OK

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General NPI Number Information
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    NPI Number           |    1629156328
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    Entity Type          |    Individual 
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    Provider Name        |    HERMAN BOYD STEPHENS DPH
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    11/01/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    2325 S HARVARD AVE SUITE 400
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74114-3300
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    Country              |    US
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    Telephone            |    918-712-3407
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    Fax                  |    919-712-3408
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Provider Business Mailing Address
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    Address Line         |    7309 S CANTON AVE 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74136-7001
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    Country              |    US
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    Telephone            |    919-495-3666
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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       |    8035
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    License Number State |    OK
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