Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. JACK LEE JUSTICE, DPH

Active Sole Proprietor

Pharmacist · PAULS VALLEY, OK

Registration Details

NPI Number: 1023189388
Provider Type: Individual
Gender: Male
NPI Issued: Nov 10, 2006 (19.45793300198 yrs)
Last Updated: Jul 8, 2007
License: 8244 (OK)
Sole Proprietor: Yes

Practice Information

Address: 110 BURR AVE

PAULS VALLEY, OK, 730753848
Browse OK providers · Browse ZIP 73075
Phone: 4052387391
Fax: 4052381162
Primary Specialty: Pharmacist
183500000X

Other Pharmacist Providers in PAULS VALLEY, OK

Name	Credential	NPI
MISS CARLA ANN BOETTLER	DPH	1629149885
MRS. CYNTHIA A. JACOBSON	DPH.	1447324611
MRS. ANN HULL	DPH	1659447324
DR. CHRISTOPHER JAMES GOLD	PHARM D	1619150422
MR. JOHN MICHAEL TEEL	PHARMD	1275861163
SARA JUSTICE	D.PH	1801353172

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.