Provider Demographics
NPI:1972226223
Name:EZZELL, RHETT ALAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:RHETT
Middle Name:ALAN
Last Name:EZZELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 JOHNNY MERCER BLVD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-2102
Mailing Address - Country:US
Mailing Address - Phone:912-897-3220
Mailing Address - Fax:
Practice Address - Street 1:150 JOHNNY MERCER BLVD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-2102
Practice Address - Country:US
Practice Address - Phone:912-897-3220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH030155183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist