Provider Demographics
NPI:1407139421
Name:WINGFIELD, WILLIAM CARTER SR (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:CARTER
Last Name:WINGFIELD
Suffix:SR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 SEDGEWICK DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-3333
Mailing Address - Country:US
Mailing Address - Phone:434-384-2250
Mailing Address - Fax:
Practice Address - Street 1:5006 OLD BOONSBORO RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503
Practice Address - Country:US
Practice Address - Phone:434-386-6412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202006670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist