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DR. GREGORY SCOTT HUENERGARDT DPH
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1902903206
Individual Registrant:DR. GREGORY SCOTT HUENERGARDT DPH
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
102 W. JANE JAYROE LAVERNE, OK 73848-1250 US
Tel: 580-921-3373 Fax: 580-921-5469
Tel: 580-921-3373 Fax: 580-921-5469
Contact information for business:
102 W. JANE JAYROE LAVERNE, OK 73848-1250 US
Tel: 580-921-3373 Fax: 580-921-5469
Tel: 580-921-3373 Fax: 580-921-5469
Registration Information:
NPI: 1902903206
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | OK | 11624 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
