Provider Demographics
NPI:1780338244
Name:STATON, JAMES ARTHUR IV (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ARTHUR
Last Name:STATON
Suffix:IV
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 1:472 KY HIGHWAY 90 W
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:KY
Mailing Address - Zip Code:42602-7519
Mailing Address - Country:US
Mailing Address - Phone:606-306-1248
Mailing Address - Fax:
Practice Address - Street 1:130 WALMART PLAZA DR UNIT 1
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-7943
Practice Address - Country:US
Practice Address - Phone:606-348-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020657183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist