Provider Demographics
NPI:1437477106
Name:DUPARC, TIMOTHY RYAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:RYAN
Last Name:DUPARC
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 1:7101 KINGFISHER ST
Mailing Address - Street 2:
Mailing Address - City:MACDILL, AFB
Mailing Address - State:FL
Mailing Address - Zip Code:33611-5205
Mailing Address - Country:US
Mailing Address - Phone:813-827-9764
Mailing Address - Fax:
Practice Address - Street 1:7101 KINGFISHER ST, MACDILL, AFB, 33621-5205
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:33621-5205
Practice Address - Country:US
Practice Address - Phone:813-827-9764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-05
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49121183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist