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General NPI Number Information
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NPI Number | 1659851392
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Entity Type | Individual
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Provider Name | DANIEL THOMAS KENT RPH
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Gender | Male
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Dates
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Enumeration Date | 08/21/2018
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Last Update Date | 08/21/2018
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Provider Practice Location Address
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Address Line | 1000 W SHAWNEE ST
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City | MUSKOGEE
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State | OK
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Zip | 74401-3509
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Country | US
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Telephone | 918-687-1231
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Fax |
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Provider Business Mailing Address
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Address Line | 5607 S GARY PL
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City | TULSA
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State | OK
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Zip | 74105-7437
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Country | US
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Telephone | 918-232-0949
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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 | 15601
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License Number State | OK
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