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General NPI Number Information
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NPI Number | 1902615164
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Entity Type | Individual
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Provider Name | REBA DAWN JONES DOCTOR OF PHARMACY
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Gender | Female
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Dates
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Enumeration Date | 01/02/2025
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 1220 N COMMERCE ST
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City | ARDMORE
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State | OK
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Zip | 73401-1806
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Country | US
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Telephone | 580-223-1041
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Fax |
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Provider Business Mailing Address
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Address Line | 413 COYOTE DR
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City | ARDMORE
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State | OK
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Zip | 73401-2086
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Country | US
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Telephone | 580-465-3093
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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 | 17375
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License Number State | OK
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