Provider Demographics
NPI:1578164976
Name:DUGGER, JUSTIN GARY (PHARMD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:GARY
Last Name:DUGGER
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 1:9218 SR-228 E
Mailing Address - Street 2:
Mailing Address - City:MACCLENNY
Mailing Address - State:FL
Mailing Address - Zip Code:32063
Mailing Address - Country:US
Mailing Address - Phone:904-259-3860
Mailing Address - Fax:904-259-2938
Practice Address - Street 1:9218 SR-228 E
Practice Address - Street 2:
Practice Address - City:MACCLENNY
Practice Address - State:FL
Practice Address - Zip Code:32063
Practice Address - Country:US
Practice Address - Phone:904-259-3860
Practice Address - Fax:904-259-2938
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS49261183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist