Provider Demographics
NPI:1205664521
Name:DODD, HALEY BROOKE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:HALEY
Middle Name:BROOKE
Last Name:DODD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:HALEY
Other - Middle Name:BROOKE
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:189 ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:MEANSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30256-2319
Mailing Address - Country:US
Mailing Address - Phone:770-876-5434
Mailing Address - Fax:
Practice Address - Street 1:747 S 8TH ST STE C
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4884
Practice Address - Country:US
Practice Address - Phone:770-228-1767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0322551835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology