Provider Demographics
NPI:1871795237
Name:BURNS, RALPH FRANKLIN (PD)
Entity type:Individual
Prefix:MR
First Name:RALPH
Middle Name:FRANKLIN
Last Name:BURNS
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 N. ROBSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72701
Mailing Address - Country:US
Mailing Address - Phone:479-443-2875
Mailing Address - Fax:479-451-8403
Practice Address - Street 1:198 N CURTIS AVE
Practice Address - Street 2:
Practice Address - City:PEA RIDGE
Practice Address - State:AR
Practice Address - Zip Code:72751-3407
Practice Address - Country:US
Practice Address - Phone:479-451-8400
Practice Address - Fax:479-451-8403
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR5645183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist