Provider Demographics
NPI:1932649852
Name:BOYETT, WALTER HILL III (RPH)
Entity Type:Individual
Prefix:MR
First Name:WALTER
Middle Name:HILL
Last Name:BOYETT
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3378 BROOKDALE AVE
Mailing Address - Street 2:SUITE H
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-2787
Mailing Address - Country:US
Mailing Address - Phone:800-558-0899
Mailing Address - Fax:800-727-5037
Practice Address - Street 1:3378 BROOKDALE AVE
Practice Address - Street 2:SUITE H
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-2787
Practice Address - Country:US
Practice Address - Phone:800-558-0899
Practice Address - Fax:800-727-5037
Is Sole Proprietor?:No
Enumeration Date:2017-02-24
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA11291183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist