Provider Demographics
NPI:1134402183
Name:SPOTTS, JOHN R (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:SPOTTS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N MISSOURI ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-1791
Mailing Address - Country:US
Mailing Address - Phone:870-702-6515
Mailing Address - Fax:870-733-0594
Practice Address - Street 1:1800 N MISSOURI ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-1791
Practice Address - Country:US
Practice Address - Phone:870-702-6515
Practice Address - Fax:870-733-0594
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR6477183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist