Provider Demographics
NPI:1477159929
Name:LESTER, RODNEY FITZGERALD JR
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:FITZGERALD
Last Name:LESTER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7055 OLD NATIONAL HWY
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30296-1665
Mailing Address - Country:US
Mailing Address - Phone:770-909-5672
Mailing Address - Fax:
Practice Address - Street 1:7055 OLD NATIONAL HWY
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30296-1665
Practice Address - Country:US
Practice Address - Phone:770-909-5672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH032264183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist