Provider Demographics
NPI:1386735967
Name:ENNIS, ARTHUR BOYD JR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:BOYD
Last Name:ENNIS
Suffix:JR
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 1:585 MORRIS MAJESTIC RD
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:AL
Mailing Address - Zip Code:35116-1246
Mailing Address - Country:US
Mailing Address - Phone:205-647-0515
Mailing Address - Fax:205-647-5666
Practice Address - Street 1:585 MORRIS MAJESTIC RD
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:AL
Practice Address - Zip Code:35116-1246
Practice Address - Country:US
Practice Address - Phone:205-647-0515
Practice Address - Fax:205-647-5666
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL13877OtherSTATE PHARMACY LICENSE