Individual
KEITH SHOLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5 SAINT VINCENT CIR, LITTLE ROCK, AR 72205-5412
(501) 664-4466
Mailing address
5 SAINT VINCENT CIR, LITTLE ROCK, AR 72205-5412
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7020
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110965047
—
AR
Enumeration date
06/08/2015
Last updated
06/08/2015
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