Provider Demographics
NPI:1184065427
Name:DUGGER, MALLORY KARLA (PHARMD)
Entity type:Individual
Prefix:
First Name:MALLORY
Middle Name:KARLA
Last Name:DUGGER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-9024
Mailing Address - Country:US
Mailing Address - Phone:270-821-3077
Mailing Address - Fax:
Practice Address - Street 1:1801 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-9024
Practice Address - Country:US
Practice Address - Phone:270-821-3077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY015969183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist