Provider Demographics
NPI:1376146035
Name:BURROUGHS, KARL II (PHARM D)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:
Last Name:BURROUGHS
Suffix:II
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13783 WINSLOW AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35475-3599
Mailing Address - Country:US
Mailing Address - Phone:205-246-9895
Mailing Address - Fax:
Practice Address - Street 1:808 VETERANS MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5809
Practice Address - Country:US
Practice Address - Phone:205-345-0531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17025183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist