Provider Demographics
NPI:1275974206
Name:CURRY, SAM R (PD)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:R
Last Name:CURRY
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:BRINKLEY
Mailing Address - State:AR
Mailing Address - Zip Code:72021-2732
Mailing Address - Country:US
Mailing Address - Phone:870-734-2853
Mailing Address - Fax:870-734-1481
Practice Address - Street 1:1311 N CHARLYNE AVE
Practice Address - Street 2:
Practice Address - City:BRINKLEY
Practice Address - State:AR
Practice Address - Zip Code:72021-2001
Practice Address - Country:US
Practice Address - Phone:870-734-1321
Practice Address - Fax:870-734-1481
Is Sole Proprietor?:No
Enumeration Date:2013-07-06
Last Update Date:2013-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD6620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist