Provider Demographics
NPI:1316033541
Name:FLINT, JOHN MICHAEL JR (BS PHARMACY)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:MICHAEL
Last Name:FLINT
Suffix:JR
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6614 INNER DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-4201
Mailing Address - Country:US
Mailing Address - Phone:608-833-5929
Mailing Address - Fax:608-442-8490
Practice Address - Street 1:3250 KINGSLEY WAY
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-4628
Practice Address - Country:US
Practice Address - Phone:608-310-9922
Practice Address - Fax:608-442-8490
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI10168-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist