Provider Demographics
NPI:1043557713
Name:PARKMAN, LARRY GENE (RPH)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:GENE
Last Name:PARKMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 HIGHWAY 74 N
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-1663
Mailing Address - Country:US
Mailing Address - Phone:770-774-2787
Mailing Address - Fax:770-774-2791
Practice Address - Street 1:1512 HIGHWAY 74 N
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-1663
Practice Address - Country:US
Practice Address - Phone:770-774-2787
Practice Address - Fax:770-774-2791
Is Sole Proprietor?:No
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH010337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist