Provider Demographics
NPI:1992111876
Name:NOBLES, JOHNNY RUDOLPH III (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JOHNNY
Middle Name:RUDOLPH
Last Name:NOBLES
Suffix:III
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 N DONAHUE DR APT D27
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36832-4802
Mailing Address - Country:US
Mailing Address - Phone:334-734-3866
Mailing Address - Fax:
Practice Address - Street 1:10 W FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36105-1655
Practice Address - Country:US
Practice Address - Phone:334-265-3336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17754183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist