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General NPI Number Information
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NPI Number | 1992111876
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Entity Type | Individual
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Provider Name | JOHNNY RUDOLPH NOBLES III PHARM. D.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 07/11/2014
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Provider Practice Location Address
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Address Line | 10 W FAIRVIEW AVE
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City | MONTGOMERY
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State | AL
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Zip | 36105-1655
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Country | US
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Telephone | 334-265-3336
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Fax |
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Provider Business Mailing Address
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Address Line | 449 N DONAHUE DR APT D27
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City | AUBURN
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State | AL
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Zip | 36832-4802
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Country | US
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Telephone | 334-734-3866
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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 | 17754
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License Number State | AL
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