Provider Demographics
NPI:1891715744
Name:FORD, WILLIAM H JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:H
Last Name:FORD
Suffix:JR
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:RR 2 BOX 9A
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:GA
Mailing Address - Zip Code:30411-9505
Mailing Address - Country:US
Mailing Address - Phone:912-567-7590
Mailing Address - Fax:
Practice Address - Street 1:200 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2981
Practice Address - Country:US
Practice Address - Phone:478-274-3238
Practice Address - Fax:478-274-3393
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA096611835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy