Provider Demographics
NPI:1275123085
Name:WHEELER, JEFFREY ZACK (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ZACK
Last Name:WHEELER
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 1:127 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72601-4227
Mailing Address - Country:US
Mailing Address - Phone:870-577-1686
Mailing Address - Fax:
Practice Address - Street 1:127 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-4227
Practice Address - Country:US
Practice Address - Phone:870-741-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD14597183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist