Provider Demographics
NPI:1235232521
Name:SONNIER, JAMES RAY (PD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RAY
Last Name:SONNIER
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2104 N OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE STATION
Mailing Address - State:MO
Mailing Address - Zip Code:65619
Mailing Address - Country:US
Mailing Address - Phone:417-466-0167
Mailing Address - Fax:
Practice Address - Street 1:600 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:MO
Practice Address - Zip Code:65712-1004
Practice Address - Country:US
Practice Address - Phone:417-466-0172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO043077183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist