IndividualActive
Jason Thibodeau
NPI 1225582661 · Pharmacist · Cushing, OK
Provider details
- NPI number
- 1225582661
- Entity type
- Individual
- Primary specialty
- PharmacistPharmacy Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 12050 (OK)
Practice location
200 S Highland Ave
Cushing, OK 74023-4117
Phone: (918) 225-5200
Fax: (918) 225-0828
Mailing address
200 S Highland Ave
Cushing, OK 74023-4117
Registry dates
- Enumerated
- 2016-08-14
- Last updated
- 2020-12-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.