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General NPI Number Information
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NPI Number | 1972221018
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Entity Type | Individual
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Provider Name | MARK STEWART FAIN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/15/2022
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 909 ALAMEDA ST
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City | NORMAN
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State | OK
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Zip | 73071-5229
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Country | US
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Telephone | 405-310-6783
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Fax |
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Provider Business Mailing Address
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Address Line | 112 HOUSTON AVE
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City | PERRYVILLE
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State | AR
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Zip | 72126-9451
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Country | US
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Telephone | 501-889-5111
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Fax | 501-889-2878
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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 | PD14636
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License Number State | OK
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