Provider Demographics
NPI:1932307394
Name:STROUD, DAVID T (RPH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:T
Last Name:STROUD
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 1:1500 OAKWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:AR
Mailing Address - Zip Code:71602-9675
Mailing Address - Country:US
Mailing Address - Phone:870-692-2373
Mailing Address - Fax:
Practice Address - Street 1:2100 BROOKWOOD DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-1734
Practice Address - Country:US
Practice Address - Phone:501-296-3311
Practice Address - Fax:501-296-3310
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6342183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR6342OtherPHARMACIST