Provider Demographics
NPI:1427412709
Name:MURPHY, JACKSON RYAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JACKSON
Middle Name:RYAN
Last Name:MURPHY
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 1:1518 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-2919
Mailing Address - Country:US
Mailing Address - Phone:803-227-4452
Mailing Address - Fax:
Practice Address - Street 1:410 UNIVERSITY PKWY
Practice Address - Street 2:SUITE 2800
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6810
Practice Address - Country:US
Practice Address - Phone:803-648-2985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist