Provider Demographics
NPI:1477840411
Name:CREEL, JAMES RANDOLPH (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RANDOLPH
Last Name:CREEL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22397 HWY 439
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70438
Mailing Address - Country:US
Mailing Address - Phone:985-848-9757
Mailing Address - Fax:
Practice Address - Street 1:26496 HWY 62
Practice Address - Street 2:
Practice Address - City:FRANKLINTON
Practice Address - State:LA
Practice Address - Zip Code:70438
Practice Address - Country:US
Practice Address - Phone:985-848-5555
Practice Address - Fax:985-848-4444
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist