Individual
DR. KEITH ALLEN RUBOTTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD.
Contact information
Practice address
1328 STADIUM BLVD, JONESBORO, AR 72401-4578
(870) 935-2532
Mailing address
1328 STADIUM BLVD, JONESBORO, AR 72401-4578
(870) 935-2532
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0000033412
TN
183500000X
Pharmacist
2007025915
MO
183500000X
Pharmacist
Primary
PD09142
AR
Other
Enumeration date
04/07/2010
Last updated
04/07/2010
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