Provider Demographics
NPI:1952329229
Name:GOBER, RICHARD ROBERT (PHARMD,CGP)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ROBERT
Last Name:GOBER
Suffix:
Gender:M
Credentials:PHARMD,CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 WOODLANDS PARK DR
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-8774
Mailing Address - Country:US
Mailing Address - Phone:601-672-7270
Mailing Address - Fax:
Practice Address - Street 1:108 WOODLANDS PARK DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-8774
Practice Address - Country:US
Practice Address - Phone:601-672-7270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-09784183500000X
GA019490183500000X
WV5227183500000X
MT4871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist