Provider Demographics
NPI:1568746261
Name:POPWELL, MARK A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:POPWELL
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 1:212 ASHETON LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-0200
Mailing Address - Country:US
Mailing Address - Phone:334-297-3722
Mailing Address - Fax:334-297-5223
Practice Address - Street 1:2515 CRAWFORD RD
Practice Address - Street 2:
Practice Address - City:PHENIX CITY
Practice Address - State:AL
Practice Address - Zip Code:36867-3629
Practice Address - Country:US
Practice Address - Phone:334-297-3722
Practice Address - Fax:334-297-5223
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL16246183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist