Provider Demographics
NPI:1467764829
Name:HAULK, JANET MARTINEZ (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:MARTINEZ
Last Name:HAULK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 FERN CT
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:GA
Mailing Address - Zip Code:30228-2988
Mailing Address - Country:US
Mailing Address - Phone:404-993-9675
Mailing Address - Fax:
Practice Address - Street 1:440 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7341
Practice Address - Country:US
Practice Address - Phone:770-507-0677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH025459183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist