Individual
JOHN ROLAND WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
10 N BEACHVIEW DR, JEKYLL ISLAND, GA 31527-0816
(912) 635-2246
(912) 635-2100
Mailing address
624 OLD PLANTATION RD, JEKYLL ISLAND, GA 31527-0724
(912) 635-3188
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9593
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9593
PHARMACIST
GA
Enumeration date
08/30/2006
Last updated
07/08/2007
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