Provider Demographics
NPI:1629097233
Name:WEAR, FLAVIL LEE II (RPH)
Entity Type:Individual
Prefix:MR
First Name:FLAVIL
Middle Name:LEE
Last Name:WEAR
Suffix:II
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 910
Mailing Address - Street 2:
Mailing Address - City:TOWN CREEK
Mailing Address - State:AL
Mailing Address - Zip Code:35672-0910
Mailing Address - Country:US
Mailing Address - Phone:256-685-3530
Mailing Address - Fax:256-685-3523
Practice Address - Street 1:2721 AL HWY 20
Practice Address - Street 2:
Practice Address - City:TOWN CREEK
Practice Address - State:AL
Practice Address - Zip Code:35672
Practice Address - Country:US
Practice Address - Phone:256-685-3530
Practice Address - Fax:256-685-3523
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11420183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist