Provider Demographics
NPI:1588772206
Name:TAUNTON, HENRY DOUGLAS JR (RPH)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:DOUGLAS
Last Name:TAUNTON
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 E PONCE DE LEON AVE
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-3444
Mailing Address - Country:US
Mailing Address - Phone:404-378-5408
Mailing Address - Fax:404-378-5400
Practice Address - Street 1:225 E PONCE DE LEON AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-3444
Practice Address - Country:US
Practice Address - Phone:404-378-5408
Practice Address - Fax:404-378-5400
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA10597183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist