Provider Demographics
NPI:1043219835
Name:HALTOM, JOAN BARKER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:BARKER
Last Name:HALTOM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:904 ARGYLL DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-2707
Mailing Address - Country:US
Mailing Address - Phone:859-236-8885
Mailing Address - Fax:859-239-6706
Practice Address - Street 1:217 S 3RD ST
Practice Address - Street 2:PHARMACY
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-1823
Practice Address - Country:US
Practice Address - Phone:859-239-1721
Practice Address - Fax:859-239-6706
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10315183500000X
FL23855183500000X
TN7529183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist