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General NPI Number Information
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NPI Number | 1841368354
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Entity Type | Individual
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Provider Name | ROGER LOWELL BAYLESS D. PH.
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 225 S MAIN ST
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City | LINDSAY
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State | OK
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Zip | 73052-5633
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Country | US
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Telephone | 405-756-4511
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Fax |
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Provider Business Mailing Address
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Address Line | 1013 RIVIERA DR
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City | NORMAN
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State | OK
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Zip | 73072-7624
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Country | US
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Telephone | 405-360-3083
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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 | 7349
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License Number State | OK
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