Provider Demographics
NPI:1902932791
Name:DAY, WILLIAM GLYNN (DPH, RPH, FASCP)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GLYNN
Last Name:DAY
Suffix:
Gender:M
Credentials:DPH, RPH, FASCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 COUNTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-5500
Mailing Address - Country:US
Mailing Address - Phone:225-324-8163
Mailing Address - Fax:225-208-1739
Practice Address - Street 1:142 COUNTRYSIDE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-5500
Practice Address - Country:US
Practice Address - Phone:225-324-8163
Practice Address - Fax:220-208-1739
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA133151835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric