Provider Demographics
NPI:1295705184
Name:AKINS, MICHAEL WAYNE (RPH)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:WAYNE
Last Name:AKINS
Suffix:
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 1:40 FOREST LANE
Mailing Address - Street 2:P O BOX 609
Mailing Address - City:WOODBURY
Mailing Address - State:GA
Mailing Address - Zip Code:30293-0609
Mailing Address - Country:US
Mailing Address - Phone:706-553-5060
Mailing Address - Fax:
Practice Address - Street 1:40 FOREST LANE
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:GA
Practice Address - Zip Code:30293
Practice Address - Country:US
Practice Address - Phone:706-553-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10311183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist