Provider Demographics
NPI:1558976407
Name:STALLWORTH, JAMES L JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:STALLWORTH
Suffix:JR
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 1:1312 WILDWOOD CROSSINGS
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-4484
Mailing Address - Country:US
Mailing Address - Phone:251-635-9197
Mailing Address - Fax:
Practice Address - Street 1:1832 ASHVILLE RD
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:AL
Practice Address - Zip Code:35094-7508
Practice Address - Country:US
Practice Address - Phone:205-702-4783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21591183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist