Provider Demographics
NPI:1487939922
Name:ROBERTSON, JAMES DOUGLAS (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:DOUGLAS
Last Name:ROBERTSON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 HARPER AVE NW STE A
Mailing Address - Street 2:
Mailing Address - City:LENOIR
Mailing Address - State:NC
Mailing Address - Zip Code:28645-5196
Mailing Address - Country:US
Mailing Address - Phone:828-754-6453
Mailing Address - Fax:828-754-5031
Practice Address - Street 1:202 HARPER AVE NW STE A
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5196
Practice Address - Country:US
Practice Address - Phone:828-754-6453
Practice Address - Fax:828-754-5031
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist