Provider Demographics
NPI:1730305830
Name:OYER, CLYDE A (RPH)
Entity type:Individual
Prefix:
First Name:CLYDE
Middle Name:A
Last Name:OYER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10370 MAPLETON ST SE
Mailing Address - Street 2:
Mailing Address - City:EAST CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44730-9718
Mailing Address - Country:US
Mailing Address - Phone:330-488-1901
Mailing Address - Fax:
Practice Address - Street 1:227 MARKET AVE N
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44702-1417
Practice Address - Country:US
Practice Address - Phone:330-452-7762
Practice Address - Fax:330-452-8938
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-13873183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist