Provider Demographics
NPI:1457493421
Name:YOUNG, JAMES D III (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:D
Last Name:YOUNG
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1461 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:GRAYSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35073-1725
Mailing Address - Country:US
Mailing Address - Phone:205-674-0680
Mailing Address - Fax:205-674-5157
Practice Address - Street 1:1461 SO MAIN STREET
Practice Address - Street 2:
Practice Address - City:GRAYSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35073-1725
Practice Address - Country:US
Practice Address - Phone:205-674-0680
Practice Address - Fax:205-674-5157
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9251183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL9251OtherSTATE PHARMACY LICENSE