Provider Demographics
NPI:1700125101
Name:TARKINGTON, JUSTIN (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:
Last Name:TARKINGTON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N BOWMAN RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-2783
Mailing Address - Country:US
Mailing Address - Phone:501-225-0703
Mailing Address - Fax:501-217-4074
Practice Address - Street 1:111 N BOWMAN RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-2783
Practice Address - Country:US
Practice Address - Phone:501-225-0703
Practice Address - Fax:501-217-4074
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD11051183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist