Provider Demographics
NPI:1538763560
Name:MCCLANAHAN, ANTHONY DANIEL (PHARM D)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:DANIEL
Last Name:MCCLANAHAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12201 HEATHFIELD LN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73173-7011
Mailing Address - Country:US
Mailing Address - Phone:405-412-1770
Mailing Address - Fax:
Practice Address - Street 1:3501 36TH AVE NW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2429
Practice Address - Country:US
Practice Address - Phone:405-307-8824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK18960183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist