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General NPI Number Information
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NPI Number | 1629796198
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Entity Type | Individual
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Provider Name | BRANDON HEATH CRYER PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2022
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Last Update Date | 12/31/2023
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Provider Practice Location Address
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Address Line | 3612 SE LEE BLVD
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City | LAWTON
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State | OK
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Zip | 73501-8451
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Country | US
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Telephone | 580-355-6400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 255
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City | TIPTON
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State | OK
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Zip | 73570-0255
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Country | US
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Telephone | 580-471-7824
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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 | 19764
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License Number State | OK
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