Provider Demographics
NPI:1992395610
Name:LINDER, WILLIAM ASHLEY (DOCTORATE PHARMACY)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ASHLEY
Last Name:LINDER
Suffix:
Gender:M
Credentials:DOCTORATE PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:JESUP
Mailing Address - State:GA
Mailing Address - Zip Code:31545-1333
Mailing Address - Country:US
Mailing Address - Phone:912-427-4288
Mailing Address - Fax:912-427-9213
Practice Address - Street 1:192 N 1ST ST
Practice Address - Street 2:
Practice Address - City:JESUP
Practice Address - State:GA
Practice Address - Zip Code:31545-1333
Practice Address - Country:US
Practice Address - Phone:912-427-4288
Practice Address - Fax:912-427-9213
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRPH42458183500000X
GARPH031422183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00038046AMedicaid