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NPI 1902857527

NPI 1902857527 : PAUL THOMAS HOLIFIELD PHARM.D. : BATESVILLE, AR

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General NPI Number Information
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    NPI Number           |    1902857527
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    Entity Type          |    Individual 
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    Provider Name        |    PAUL THOMAS HOLIFIELD PHARM.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/16/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    1595 HARRISON ST 
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    City                 |    BATESVILLE
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    State                |    AR
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    Zip                  |    72501-7222
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    Country              |    US
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    Telephone            |    870-793-4179
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    Fax                  |    870-793-7303
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Provider Business Mailing Address
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    Address Line         |    1595 HARRISON ST 
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    City                 |    BATESVILLE
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    State                |    AR
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    Zip                  |    72501-7222
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    Country              |    US
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    Telephone            |    870-793-4179
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    Fax                  |    870-793-7303
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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       |    7129
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    License Number State |    AR
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