Provider Demographics
NPI:1275831026
Name:BESS, DONALD EUGENE (RPH)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:EUGENE
Last Name:BESS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1050 STONEBRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-2081
Mailing Address - Country:US
Mailing Address - Phone:706-296-3574
Mailing Address - Fax:770-786-6727
Practice Address - Street 1:3215 HIGHWAY 278 NW
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2202
Practice Address - Country:US
Practice Address - Phone:770-786-1131
Practice Address - Fax:770-786-6727
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-03
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA15564183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist