NPI 1073523932

David Eugene Nicklas, DPH

Practitioner Pharmacist Shawnee, OK

Practice location

Address: 1442 N Harrison St, Shawnee, OK 74801-5208
Phone: (405) 273-9906
Fax: (405) 273-4329
Mailing address: 1807 Henson CT, Shawnee, OK 74804-4240

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 9416 (OK)

Other Pharmacist providers in Oklahoma →

Registry record

NPI: 1073523932
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Aug 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.