Individual
MR. JOSEPH CLYDE BROGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
110 E MAIN ST, LAKELAND, GA 31635-1116
(229) 482-3677
(229) 482-2072
Mailing address
110 E MAIN ST, LAKELAND, GA 31635-1116
(229) 482-3677
(229) 482-2072
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10831
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10831
PHARMACY LICENSE #
GA
Enumeration date
07/05/2006
Last updated
07/08/2007
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