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Individual

DR. JOHN BARSON MOULTON II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM. D.

Contact information

Practice address
343 LEE ROAD 593, PHENIX CITY, AL 36870-7943
(706) 442-1377
Mailing address
343 LEE ROAD 593, PHENIX CITY, AL 36870-7943
(706) 442-1377

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
17772
AL
183500000X
Pharmacist
RPH028223
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
17772
ALABAMA BOARD OF PHARMACY
AL
01
RPH028223
GEORGIA BOARD OF PHARMACY
GA
Enumeration date
02/26/2015
Last updated
02/26/2015
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