Provider Demographics
NPI:1679129340
Name:SMITH, ANTHONY WILLIAM (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:WILLIAM
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 GROVE RD
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29907-1011
Mailing Address - Country:US
Mailing Address - Phone:229-539-6431
Mailing Address - Fax:
Practice Address - Street 1:61 LADYS ISLAND DR
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29907-1618
Practice Address - Country:US
Practice Address - Phone:843-986-9658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-17
Last Update Date:2019-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC42207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist