Provider Demographics
NPI:1962599779
Name:SEEFELDT, ALAN RAY (DPH)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:RAY
Last Name:SEEFELDT
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 S LEGENDARY LN
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-2153
Mailing Address - Country:US
Mailing Address - Phone:405-377-4257
Mailing Address - Fax:405-372-3547
Practice Address - Street 1:1723 W 6TH AV
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074
Practice Address - Country:US
Practice Address - Phone:405-372-3331
Practice Address - Fax:405-372-3547
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8260183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist