Provider Demographics
NPI:1891032967
Name:GUNN, WILLIAM CROCKETT (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CROCKETT
Last Name:GUNN
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 1:5400 SW COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-5756
Mailing Address - Country:US
Mailing Address - Phone:352-873-1038
Mailing Address - Fax:352-873-7675
Practice Address - Street 1:5400 SW COLLEGE RD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-5756
Practice Address - Country:US
Practice Address - Phone:352-873-1038
Practice Address - Fax:352-873-7675
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS26481183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist