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General NPI Number Information
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NPI Number | 1275836090
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Entity Type | Individual
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Provider Name | JUSTIN K FUSELIER PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 12/16/2010
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 1013 E LANDRY ST
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City | OPELOUSAS
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State | LA
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Zip | 70570-7388
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Country | US
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Telephone | 337-942-5738
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Fax | 373-481-0383
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Provider Business Mailing Address
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Address Line | 181 FUSELIER RD
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City | OPELOUSAS
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State | LA
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Zip | 70570-1528
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Country | US
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Telephone | 337-316-6537
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16719
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License Number State | LA
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