Provider Demographics
NPI:1275750853
Name:DOLL, GREGORY HARRY (RPH)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:HARRY
Last Name:DOLL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27701 C.R. 354
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:MI
Mailing Address - Zip Code:49065
Mailing Address - Country:US
Mailing Address - Phone:269-624-3671
Mailing Address - Fax:
Practice Address - Street 1:206 SOUTH STATE ST.
Practice Address - Street 2:
Practice Address - City:GOBLES
Practice Address - State:MI
Practice Address - Zip Code:49055
Practice Address - Country:US
Practice Address - Phone:269-628-2650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302022461183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist