Individual
DR. JOHN CHARLES ETHERIEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1018 MAIN ST, GARDENDALE, AL 35071
(205) 631-8701
(205) 631-8705
Mailing address
300 MEMORY LANE, HAYDEN, AL 35079-4465
(205) 647-8888
(205) 647-8888
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
7818
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7818
STATE OF ALABAMA
AL
Enumeration date
06/27/2011
Last updated
06/27/2011
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