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NPI Code Detail

MEDICARE: MR. DENNIS EDWARD DUFOUR D.PH.

MEDICARE: MR. DENNIS EDWARD DUFOUR D.PH.
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
1183500000XPharmacist9619OK

General Provider Information

NPI Number : 1447262787
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DENNIS EDWARD DUFOUR D.PH.
Provider Business Mailing Address
First Line : 630 S 105TH EAST PL
Second Line :
City : TULSA
State : OK
Zip : 74128-2818
Country : US
Telephone Number : 918-438-6208
Fax Number :
Provider Business Practice Location Address
First Line : 4112 S PEORIA AVE
Second Line :
City : TULSA
State : OK
Zip : 74105-7613
Country : US
Telephone Number : 918-743-4491
Fax Number : 918-743-5432
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2006
Last Update Date : 07/08/2007

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Directions to “ MR. DENNIS EDWARD DUFOUR D.PH.” Practice Location

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