Provider Demographics
NPI:1093255895
Name:AYERS, WILLIAM BRYAN (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:BRYAN
Last Name:AYERS
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 1:1950 COMMONWEALTH LN
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-3196
Mailing Address - Country:US
Mailing Address - Phone:800-873-1335
Mailing Address - Fax:800-873-1338
Practice Address - Street 1:1950 COMMONWEALTH LN
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-3196
Practice Address - Country:US
Practice Address - Phone:800-873-1335
Practice Address - Fax:800-873-1338
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS25678183500000X
FLPU5649183500000X
CO13932183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist