Provider Demographics
NPI:1932404951
Name:SPITZFADEN, ARIE R (RPH)
Entity Type:Individual
Prefix:MR
First Name:ARIE
Middle Name:R
Last Name:SPITZFADEN
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 1:1032 RAMBLEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WOODWORTH
Mailing Address - State:LA
Mailing Address - Zip Code:71485-3001
Mailing Address - Country:US
Mailing Address - Phone:318-449-1615
Mailing Address - Fax:
Practice Address - Street 1:1032 RAMBLEVIEW DR
Practice Address - Street 2:
Practice Address - City:WOODWORTH
Practice Address - State:LA
Practice Address - Zip Code:71485-3001
Practice Address - Country:US
Practice Address - Phone:318-449-1615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-22
Last Update Date:2011-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA154921835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist