Provider Demographics
NPI:1275011207
Name:ESTRADA, JOSEPH CLINT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CLINT
Last Name:ESTRADA
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 1:1709 WHEATON TRCE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72908-0797
Mailing Address - Country:US
Mailing Address - Phone:575-635-7953
Mailing Address - Fax:
Practice Address - Street 1:7700 ROGERS AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5252
Practice Address - Country:US
Practice Address - Phone:479-484-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-01
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD16011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist