Provider Demographics
NPI:1356774632
Name:STUDSTILL, EDWIN (RPH)
Entity type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:
Last Name:STUDSTILL
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 1:107 PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3643
Mailing Address - Country:US
Mailing Address - Phone:229-931-6312
Mailing Address - Fax:229-931-9359
Practice Address - Street 1:107 PRINCE ST
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3643
Practice Address - Country:US
Practice Address - Phone:229-931-6312
Practice Address - Fax:229-931-9359
Is Sole Proprietor?:No
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8726183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist