Healthcare Provider Details

I. General information

NPI: 1487660858
Provider Name (Legal Business Name): JAMES R. BUETTNER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

IV. Provider business mailing address

12020C COUNTY ROAD 54
DAPHNE AL
36526-8446
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-4099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number8020
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: