Provider Demographics
NPI:1063681070
Name:PARKS-VEAL, PHYLLIS M (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:PHYLLIS
Middle Name:M
Last Name:PARKS-VEAL
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 ARBOR WAY
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-7789
Mailing Address - Country:US
Mailing Address - Phone:478-452-1351
Mailing Address - Fax:
Practice Address - Street 1:151 ARBOR WAY
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-7789
Practice Address - Country:US
Practice Address - Phone:478-452-1351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-23
Last Update Date:2008-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10269183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist