Provider Demographics
NPI:1124781471
Name:WILLIAMS, ANTHONY JARREAU (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JARREAU
Last Name:WILLIAMS
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 1:610 BUOY DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32507-8696
Mailing Address - Country:US
Mailing Address - Phone:561-222-1604
Mailing Address - Fax:
Practice Address - Street 1:610 BUOY DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-8696
Practice Address - Country:US
Practice Address - Phone:561-222-1604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS62678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist