MEDICARE: JOHN JOINES

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	13160	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13160	OTHER	OK	OK LICENSE

General Provider Information

NPI Number	:	1518038124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN JOINES

Provider Business Mailing Address
First Line	:	1001 N COUNTRY CLUB RD
Second Line	:
City	:	ADA
State	:	OK
Zip	:	74820-2847
Country	:	US
Telephone Number	:	580-421-4570
Fax Number	:	580-421-6283

Provider Business Practice Location Address
First Line	:	1600 N WASHINGTON AVE
Second Line	:
City	:	DURANT
State	:	OK
Zip	:	74701-2128
Country	:	US
Telephone Number	:	580-920-2100
Fax Number	:	580-559-0610

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	07/23/2007

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Directions to “ JOHN JOINES ” Practice Location

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