Provider Demographics
NPI:1588711550
Name:STADLER, ANGELA NORMAN (RPH)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:NORMAN
Last Name:STADLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 W HILL ST
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-2116
Mailing Address - Country:US
Mailing Address - Phone:706-595-4842
Mailing Address - Fax:
Practice Address - Street 1:433 W HILL ST
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-2116
Practice Address - Country:US
Practice Address - Phone:706-595-4842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH018011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist