Provider Demographics
NPI:1154436079
Name:LOTT, RICHARD K (PHARM D)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:K
Last Name:LOTT
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 JOHN MOORE RD
Mailing Address - Street 2:
Mailing Address - City:WEST GREEN
Mailing Address - State:GA
Mailing Address - Zip Code:31567-4099
Mailing Address - Country:US
Mailing Address - Phone:912-383-6506
Mailing Address - Fax:
Practice Address - Street 1:302 S WAYNE ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:GA
Practice Address - Zip Code:31510-2922
Practice Address - Country:US
Practice Address - Phone:912-632-8961
Practice Address - Fax:912-632-2231
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA19025183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist