Provider Demographics
NPI:1407454168
Name:LAIRSEY, STION (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STION
Middle Name:
Last Name:LAIRSEY
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 1:1100 HILLCREST PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-4373
Mailing Address - Country:US
Mailing Address - Phone:478-277-3085
Mailing Address - Fax:
Practice Address - Street 1:1100 HILLCREST PKWY STE A
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-4373
Practice Address - Country:US
Practice Address - Phone:478-277-3085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH030864183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist