Provider Demographics
NPI:1437653730
Name:BARWICK, THOMAS SHAY II
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:SHAY
Last Name:BARWICK
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 SHADEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32327-1410
Mailing Address - Country:US
Mailing Address - Phone:850-519-4385
Mailing Address - Fax:
Practice Address - Street 1:4650 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-9419
Practice Address - Country:US
Practice Address - Phone:334-792-6824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19487183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist