Provider Demographics
NPI:1881986792
Name:RUTLEDGE, TOBY K (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TOBY
Middle Name:K
Last Name:RUTLEDGE
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 1:9143 PHILIPS HWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-1348
Mailing Address - Country:US
Mailing Address - Phone:904-363-3089
Mailing Address - Fax:904-363-6161
Practice Address - Street 1:9143 PHILIPS HWY
Practice Address - Street 2:SUITE 300
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-1348
Practice Address - Country:US
Practice Address - Phone:904-363-3089
Practice Address - Fax:904-363-6161
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS47055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist