Provider Demographics
NPI:1427386101
Name:HIXSON-WALLACE, JULIE ANN (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:HIXSON-WALLACE
Suffix:
Gender:F
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 E MARKET AVE
Mailing Address - Street 2:BOX 12230
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72149-2230
Mailing Address - Country:US
Mailing Address - Phone:501-279-5205
Mailing Address - Fax:
Practice Address - Street 1:915 E MARKET AVE
Practice Address - Street 2:BOX 12230
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72149-2230
Practice Address - Country:US
Practice Address - Phone:501-279-5205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD104681835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy