Provider Demographics
NPI:1508419003
Name:COXHEAD, DARBY JETER (PHARMD)
Entity Type:Individual
Prefix:
First Name:DARBY
Middle Name:JETER
Last Name:COXHEAD
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 1:5598 GUYTON CT
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-2032
Mailing Address - Country:US
Mailing Address - Phone:678-896-6368
Mailing Address - Fax:
Practice Address - Street 1:5598 GUYTON CT
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-2032
Practice Address - Country:US
Practice Address - Phone:678-896-6368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH031492183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist