Provider Demographics
NPI:1295087633
Name:UZODIKE, PATRICK (PHARM D, BSC)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:UZODIKE
Suffix:
Gender:M
Credentials:PHARM D, BSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 RONALD REAGAN DR
Mailing Address - Street 2:SUITE 269
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-7700
Mailing Address - Country:US
Mailing Address - Phone:678-663-1177
Mailing Address - Fax:
Practice Address - Street 1:607 RONALD REAGAN DR
Practice Address - Street 2:SUITE 269
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-7700
Practice Address - Country:US
Practice Address - Phone:678-663-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15441183500000X
GARPH0229521835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist