Provider Demographics
NPI:1902408859
Name:BAGSBY, RAYFORD D JR (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:RAYFORD
Middle Name:D
Last Name:BAGSBY
Suffix:JR
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 WALTON DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-4108
Mailing Address - Country:US
Mailing Address - Phone:678-588-2541
Mailing Address - Fax:
Practice Address - Street 1:713 WALTON DR
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-4108
Practice Address - Country:US
Practice Address - Phone:678-583-8160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-14
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023222183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist