Provider Demographics
NPI:1598289167
Name:HARTSELL, DAVID BRADFORD JR (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BRADFORD
Last Name:HARTSELL
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 1:2190 GILMER AVE
Mailing Address - Street 2:
Mailing Address - City:TALLASSEE
Mailing Address - State:AL
Mailing Address - Zip Code:36078-7123
Mailing Address - Country:US
Mailing Address - Phone:334-991-3207
Mailing Address - Fax:334-991-3101
Practice Address - Street 1:2190 GILMER AVE
Practice Address - Street 2:
Practice Address - City:TALLASSEE
Practice Address - State:AL
Practice Address - Zip Code:36078-7123
Practice Address - Country:US
Practice Address - Phone:334-991-3207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-26
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist