Provider Demographics
NPI:1760821730
Name:BIXLER, RALPH GIRARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:GIRARD
Last Name:BIXLER
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 1:290 N 2ND CT
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-2402
Mailing Address - Country:US
Mailing Address - Phone:541-269-0757
Mailing Address - Fax:
Practice Address - Street 1:1020 1ST ST
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-3806
Practice Address - Country:US
Practice Address - Phone:541-269-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-22
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO027329183500000X
OR00087921835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist