Provider Demographics
NPI:1992147490
Name:SHERIDAN, JAMES ANTHONY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANTHONY
Last Name:SHERIDAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BLYTHEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72315-1702
Mailing Address - Country:US
Mailing Address - Phone:870-763-4507
Mailing Address - Fax:
Practice Address - Street 1:900 N 6TH ST
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-1702
Practice Address - Country:US
Practice Address - Phone:870-763-4507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-24
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12381183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist