Provider Demographics
NPI:1245374164
Name:REESE, GEORGE II (RPH)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:REESE
Suffix:II
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 LAKE FOREST WAY
Mailing Address - Street 2:
Mailing Address - City:MAYLENE
Mailing Address - State:AL
Mailing Address - Zip Code:35114-4917
Mailing Address - Country:US
Mailing Address - Phone:205-620-0107
Mailing Address - Fax:
Practice Address - Street 1:1352 E HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36703-3210
Practice Address - Country:US
Practice Address - Phone:334-872-9501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL10955183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist