Provider Demographics
NPI:1407371180
Name:SEDBERRY, JACOB AUSTIN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:AUSTIN
Last Name:SEDBERRY
Suffix:
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 1:250 COTTONSTONE LN
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:NC
Mailing Address - Zip Code:27371-8399
Mailing Address - Country:US
Mailing Address - Phone:910-572-1396
Mailing Address - Fax:
Practice Address - Street 1:1206 E BROAD AVE
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-4902
Practice Address - Country:US
Practice Address - Phone:910-572-1396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27118183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist