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NPI Code Detail

MEDICARE: CLIFTON CLAY NOLES

MEDICARE: CLIFTON CLAY NOLES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH026068GA

General Provider Information

NPI Number : 1952687055
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLIFTON CLAY NOLES
Provider Business Mailing Address
First Line : 794 S PARK ST
Second Line :
City : CARROLLTON
State : GA
Zip : 30117-3826
Country : US
Telephone Number : 770-838-1678
Fax Number :
Provider Business Practice Location Address
First Line : 794 S PARK ST
Second Line :
City : CARROLLTON
State : GA
Zip : 30117-3826
Country : US
Telephone Number : 770-838-1678
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2011
Last Update Date : 11/02/2011

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Directions to “ CLIFTON CLAY NOLES ” Practice Location

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