Provider Demographics
NPI:1063750149
Name:DU PLESSIS, JACOB J
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:J
Last Name:DU PLESSIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 TUNNEL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2037
Mailing Address - Country:US
Mailing Address - Phone:828-298-1425
Mailing Address - Fax:828-298-2523
Practice Address - Street 1:1141 TUNNEL RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2037
Practice Address - Country:US
Practice Address - Phone:828-298-1425
Practice Address - Fax:828-298-2523
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18688183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist