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Individual

DONALD RAY EZELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
2403 FLORENCE BLVD, FLORENCE, AL 35630-2877
(256) 766-7450
Mailing address
5320 HIGHWAY 17, FLORENCE, AL 35634-9006
(256) 760-9548

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10302
AL
183500000X
Pharmacist
8720
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10302
PHARMACY LICENSE
AL
Enumeration date
03/08/2011
Last updated
03/08/2011
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