Provider Demographics
NPI:1427338912
Name:HACKLER, RONALD L (RPH)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:L
Last Name:HACKLER
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 1:6415 E PINE ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74115-5432
Mailing Address - Country:US
Mailing Address - Phone:918-834-0582
Mailing Address - Fax:918-834-5195
Practice Address - Street 1:6415 E PINE ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74115-5432
Practice Address - Country:US
Practice Address - Phone:918-834-0582
Practice Address - Fax:918-834-5195
Is Sole Proprietor?:No
Enumeration Date:2011-08-28
Last Update Date:2011-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9842183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist