Provider Demographics
NPI:1407934623
Name:STILLES, JAMES RANDALL (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RANDALL
Last Name:STILLES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:MR
Other - First Name:RANDY
Other - Middle Name:
Other - Last Name:STILES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:R PH
Mailing Address - Street 1:93 GLENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-2284
Mailing Address - Country:US
Mailing Address - Phone:606-433-1688
Mailing Address - Fax:
Practice Address - Street 1:6162 ZEBULON HIGHWAY
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501
Practice Address - Country:US
Practice Address - Phone:606-631-9137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY009488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist