Provider Demographics
NPI:1639436116
Name:MARLOW, JOSEPH KYLE (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:KYLE
Last Name:MARLOW
Suffix:
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 1:337 MARLOW WAY
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-9657
Mailing Address - Country:US
Mailing Address - Phone:706-264-5752
Mailing Address - Fax:
Practice Address - Street 1:1006 PROFESSIONAL BLVD
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-2714
Practice Address - Country:US
Practice Address - Phone:706-217-2700
Practice Address - Fax:706-278-8071
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA17622183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist