Provider Demographics
NPI:1154862076
Name:KERCHER, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:KERCHER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4260 WINDER HWY
Mailing Address - Street 2:
Mailing Address - City:FLOWERY BRANCH
Mailing Address - State:GA
Mailing Address - Zip Code:30542-3603
Mailing Address - Country:US
Mailing Address - Phone:770-965-8928
Mailing Address - Fax:770-965-4067
Practice Address - Street 1:4260 WINDER HWY
Practice Address - Street 2:
Practice Address - City:FLOWERY BRANCH
Practice Address - State:GA
Practice Address - Zip Code:30542-3603
Practice Address - Country:US
Practice Address - Phone:770-965-8928
Practice Address - Fax:770-965-4067
Is Sole Proprietor?:No
Enumeration Date:2017-03-10
Last Update Date:2017-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0140994183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist