Provider Demographics
NPI:1477554095
Name:ANDERSON, DOUGLAS CALVIN JR (PHARMD, DPH)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:CALVIN
Last Name:ANDERSON
Suffix:JR
Gender:M
Credentials:PHARMD, DPH
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Mailing Address - Street 1:2103 NOTTINGHAM WAY
Mailing Address - Street 2:APT. 5
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-1112
Mailing Address - Country:US
Mailing Address - Phone:229-431-0833
Mailing Address - Fax:815-425-7982
Practice Address - Street 1:1712A E BROAD AVE
Practice Address - Street 2:EAST ALBANY MEDICAL CENTER
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31705-2611
Practice Address - Country:US
Practice Address - Phone:229-639-3100
Practice Address - Fax:229-430-3223
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-04
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
GARPH0219711835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy