Provider Demographics
NPI:1538135728
Name:WETZEL, JEFFREY ALLEN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALLEN
Last Name:WETZEL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4191 MOUNTAIN VIEW RD
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-8342
Mailing Address - Country:US
Mailing Address - Phone:209-634-7887
Mailing Address - Fax:
Practice Address - Street 1:1300 W OLIVE AVE
Practice Address - Street 2:SAVE MART PHARMACY #391
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-1663
Practice Address - Country:US
Practice Address - Phone:209-723-2111
Practice Address - Fax:209-723-4218
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50187183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist