Provider Demographics
NPI:1043577653
Name:HALBIG, DEBRA S
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:S
Last Name:HALBIG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5760 FOUR WINDS DR SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-6420
Mailing Address - Country:US
Mailing Address - Phone:770-717-1063
Mailing Address - Fax:
Practice Address - Street 1:5760 FOUR WINDS DR SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-6420
Practice Address - Country:US
Practice Address - Phone:770-717-1063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH016651183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist