Healthcare Provider Details

I. General information

NPI: 1538166426
Provider Name (Legal Business Name): PHILLIP L THORNTON R.PH, PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7200 MATTHEWS MINT HILL RD
MINT HILL NC
28227-7593
US

IV. Provider business mailing address

4713 CARVING TREE DR
MINT HILL NC
28227-8807
US

V. Phone/Fax

Practice location:
  • Phone: 704-910-2718
  • Fax: 704-910-6441
Mailing address:
  • Phone: 704-499-5890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number14350
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number11048
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: