MEDICARE: DR. MARK ALLEN STRIMPLE PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	8905	OK

General Provider Information

NPI Number	:	1396822094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK ALLEN STRIMPLE PH.D.

Provider Business Mailing Address
First Line	:	3912 SE 41ST PL
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73165-7363
Country	:	US
Telephone Number	:	405-799-2756
Fax Number	:	405-733-7061

Provider Business Practice Location Address
First Line	:	7201 E RENO AVE STE A
Second Line	:
City	:	MIDWEST CITY
State	:	OK
Zip	:	73110-4484
Country	:	US
Telephone Number	:	405-737-3451
Fax Number	:	405-733-7061

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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