Provider Demographics
NPI:1235754409
Name:WATFORD, LINDSEY S (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:S
Last Name:WATFORD
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:PO BOX 120
Mailing Address - Street 2:
Mailing Address - City:GRAVETTE
Mailing Address - State:AR
Mailing Address - Zip Code:72736-0120
Mailing Address - Country:US
Mailing Address - Phone:479-787-5966
Mailing Address - Fax:
Practice Address - Street 1:205 ATLANTA ST SE
Practice Address - Street 2:
Practice Address - City:GRAVETTE
Practice Address - State:AR
Practice Address - Zip Code:72736-9364
Practice Address - Country:US
Practice Address - Phone:479-957-7867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR10858183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist