Provider Demographics
NPI:1528198132
Name:EDDINGTON, DAVID BRADLEY (PD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BRADLEY
Last Name:EDDINGTON
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 GREENE ROAD 733
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-6199
Mailing Address - Country:US
Mailing Address - Phone:870-240-0179
Mailing Address - Fax:870-597-2217
Practice Address - Street 1:831 GREENE ROAD 733
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-6199
Practice Address - Country:US
Practice Address - Phone:870-240-0179
Practice Address - Fax:870-597-2217
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD07791183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARPD07791OtherPHARMACIST LIC #