Provider Demographics
NPI:1649478496
Name:TROTTER, FRANK M (RPH)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:M
Last Name:TROTTER
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 1:306 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIA
Mailing Address - State:GA
Mailing Address - Zip Code:30531-2218
Mailing Address - Country:US
Mailing Address - Phone:706-778-2893
Mailing Address - Fax:706-894-2717
Practice Address - Street 1:184B PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:BALDWIN
Practice Address - State:GA
Practice Address - Zip Code:30511-4009
Practice Address - Country:US
Practice Address - Phone:706-894-2716
Practice Address - Fax:706-894-2717
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH010898183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARPH010898OtherPHARMACY LICENSE