Provider Demographics
NPI:1649315664
Name:BOND, WILLIAM D (BS PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:D
Last Name:BOND
Suffix:
Gender:M
Credentials:BS PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 SUMMITT ST
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-5314
Mailing Address - Country:US
Mailing Address - Phone:901-276-5696
Mailing Address - Fax:
Practice Address - Street 1:430 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-2904
Practice Address - Country:US
Practice Address - Phone:870-732-3744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5069183500000X
AR8985183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist