Clifford Blaine Polk
Pharmacist, Ambulatory Care in Hugo, OK. Individual provider (NPI-1).
NPI number1174166300
StatusActive
Last updated in NPPESOct 21, 2019
Details
- NPI
- 1174166300
- Entity type
- Individual (NPI-1)
- Name
- Clifford Blaine Polk
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 21, 2019
- Last updated
- Oct 21, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1835P2201X | Pharmacist, Ambulatory Care | 10516 | OK | Yes |
Practice location
420 E Jackson StHugo, OK 74743-4021
Phone 580-326-8337 · Fax 580-326-8338
Mailing address
420 E Jackson StHugo, OK 74743-4021
Phone 580-326-8337 · Fax 580-326-8338
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