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Individual

DR. JODI LYNN WAUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
2730 HIGHWAY 155, LOCUST GROVE, GA 30248-2401
(404) 825-6632
Mailing address
149 HUNTERS CHASE, MCDONOUGH, GA 30253-7440
(404) 825-6632

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-027159
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RPH-027159
GA STATE BOARD OF PHARMACY
GA
Enumeration date
04/17/2019
Last updated
11/27/2023
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