Provider Demographics
NPI:1518232263
Name:DAVIS, WILBURN TURNER II (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:WILBURN
Middle Name:TURNER
Last Name:DAVIS
Suffix:II
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2565 CAPITAL MEDICAL BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4423
Mailing Address - Country:US
Mailing Address - Phone:850-219-0202
Mailing Address - Fax:
Practice Address - Street 1:2565 CAPITAL MEDICAL BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4423
Practice Address - Country:US
Practice Address - Phone:850-219-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-14
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS15370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist