Provider Demographics
NPI:1508164070
Name:CARLTON, JULIE MOSS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MOSS
Last Name:CARLTON
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 1:802 NATHAN DEAN BYPASS
Mailing Address - Street 2:
Mailing Address - City:ROCKMART
Mailing Address - State:GA
Mailing Address - Zip Code:30153
Mailing Address - Country:US
Mailing Address - Phone:770-684-6547
Mailing Address - Fax:770-684-4391
Practice Address - Street 1:802 NATHAN DEAN BYPASS
Practice Address - Street 2:
Practice Address - City:ROCKMART
Practice Address - State:GA
Practice Address - Zip Code:30153
Practice Address - Country:US
Practice Address - Phone:770-684-6547
Practice Address - Fax:770-684-4391
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA023762183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist