Provider Demographics
NPI:1194816645
Name:DILLARD, KASEY GARRISH (PHARMD)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:GARRISH
Last Name:DILLARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 POWER CENTER DR
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-9431
Mailing Address - Country:US
Mailing Address - Phone:706-265-2484
Mailing Address - Fax:706-265-2487
Practice Address - Street 1:98 POWER CENTER DR
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-9431
Practice Address - Country:US
Practice Address - Phone:706-265-2484
Practice Address - Fax:706-265-2487
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist