Provider Demographics
NPI:1659971356
Name:MURDOCK, JEFFERY ZACK (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:ZACK
Last Name:MURDOCK
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 N LEE ST
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-2182
Mailing Address - Country:US
Mailing Address - Phone:478-994-6005
Mailing Address - Fax:
Practice Address - Street 1:180 N LEE ST
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-2182
Practice Address - Country:US
Practice Address - Phone:478-994-6005
Practice Address - Fax:478-994-8784
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20159183500000X
GARPH028876183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist