Provider Demographics
NPI:1447363353
Name:POSTIER, JUSTIN RAY (DPH)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:RAY
Last Name:POSTIER
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10827 S MEMORIAL DR STE I
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-7361
Mailing Address - Country:US
Mailing Address - Phone:918-921-8134
Mailing Address - Fax:918-921-8135
Practice Address - Street 1:10827 S MEMORIAL DR STE I
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-7361
Practice Address - Country:US
Practice Address - Phone:918-921-8134
Practice Address - Fax:918-921-8135
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12763183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK12763OtherOKLAHOMA STATE BOARD OF PHARMACY