Provider Demographics
NPI:1790085389
Name:TEMPLES, RONALD CRAIG (RPH)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:CRAIG
Last Name:TEMPLES
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 1:313 W. PATTON AVE.
Mailing Address - Street 2:FRED'S PHARMACY
Mailing Address - City:LA FAYETTE
Mailing Address - State:GA
Mailing Address - Zip Code:30728-2927
Mailing Address - Country:US
Mailing Address - Phone:706-638-6931
Mailing Address - Fax:706-638-8936
Practice Address - Street 1:313 W PATTON ST
Practice Address - Street 2:
Practice Address - City:LA FAYETTE
Practice Address - State:GA
Practice Address - Zip Code:30728-2950
Practice Address - Country:US
Practice Address - Phone:706-638-6931
Practice Address - Fax:706-638-8936
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-28
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11631183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist