Provider Demographics
NPI:1275871022
Name:EDWARDS, WILLIAM DAUGHARTY JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DAUGHARTY
Last Name:EDWARDS
Suffix:JR
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 1:1741 GORNTO RD
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31601-8408
Mailing Address - Country:US
Mailing Address - Phone:229-242-2409
Mailing Address - Fax:
Practice Address - Street 1:1741 GORNTO RD
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31601-8408
Practice Address - Country:US
Practice Address - Phone:229-242-2409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH026115183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist