Individual
JEFFREY PADGETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
955 S 1ST ST, JESUP, GA 31545-0331
(912) 427-6239
Mailing address
955 S 1ST ST, JESUP, GA 31545-0331
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
024823
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051101499
DRIVER'S LICENSE
GA
Enumeration date
05/14/2019
Last updated
05/14/2019
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