Provider Demographics
NPI:1033308911
Name:HONEYCUTT, GARY ALLAN II (LPN)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:ALLAN
Last Name:HONEYCUTT
Suffix:II
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 SCENIC DR
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35904-3263
Mailing Address - Country:US
Mailing Address - Phone:256-328-3989
Mailing Address - Fax:
Practice Address - Street 1:622 BROAD ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-3722
Practice Address - Country:US
Practice Address - Phone:256-328-3989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL113017183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician