Provider Demographics
NPI:1205119740
Name:PONDER, WILLIAM NORMAN JR (RPH)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:NORMAN
Last Name:PONDER
Suffix:JR
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:PO BOX 368
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787
Mailing Address - Country:US
Mailing Address - Phone:828-645-6477
Mailing Address - Fax:
Practice Address - Street 1:65 WEAVER BLVD
Practice Address - Street 2:KERR 123
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787
Practice Address - Country:US
Practice Address - Phone:828-645-6477
Practice Address - Fax:828-645-5887
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC078381835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy