Provider Demographics
NPI:1770850430
Name:NEWKIRK, AL GORDON (RPH)
Entity Type:Individual
Prefix:MR
First Name:AL
Middle Name:GORDON
Last Name:NEWKIRK
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 1:68 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-2722
Mailing Address - Country:US
Mailing Address - Phone:828-586-7150
Mailing Address - Fax:828-586-7153
Practice Address - Street 1:68 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-2722
Practice Address - Country:US
Practice Address - Phone:828-586-7150
Practice Address - Fax:828-586-7153
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18560183500000X
AL12377183500000X
LA14256183500000X
FL26302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist