Provider Demographics
NPI:1740522796
Name:MCMAHAN, JAMES CLOVIS (BS PHARMACY)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:CLOVIS
Last Name:MCMAHAN
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 SPARLING RD
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-8858
Mailing Address - Country:US
Mailing Address - Phone:501-767-4136
Mailing Address - Fax:
Practice Address - Street 1:1340 HIGDON FERRY RD
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6411
Practice Address - Country:US
Practice Address - Phone:501-623-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-17
Last Update Date:2013-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist