Provider Demographics
NPI:1235322447
Name:STUBBS, WILLIAM COURTNEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:COURTNEY
Last Name:STUBBS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 GREENRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-5352
Mailing Address - Country:US
Mailing Address - Phone:904-716-2453
Mailing Address - Fax:
Practice Address - Street 1:1225 GREENRIDGE RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-5352
Practice Address - Country:US
Practice Address - Phone:904-716-2453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2013-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 16644183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist