Individual
DR. KENNETH ISHAM JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
109 W HILL ST, THOMSON, GA 30824-2110
(706) 595-6666
(706) 597-7023
Mailing address
109 W HILL ST, THOMSON, GA 30824-2110
(706) 595-6666
(706) 597-7023
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
019205
GA
Other
Enumeration date
12/03/2020
Last updated
12/03/2020
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