Provider Demographics
NPI:1205194446
Name:CAUSEY, MARCIE JILL (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MARCIE
Middle Name:JILL
Last Name:CAUSEY
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 1:115 S AIRLINE HWY
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-3633
Mailing Address - Country:US
Mailing Address - Phone:225-647-7980
Mailing Address - Fax:225-647-8369
Practice Address - Street 1:115 S AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-3633
Practice Address - Country:US
Practice Address - Phone:225-647-7980
Practice Address - Fax:225-647-8369
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17744183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist