Patrick J Southall, RPH

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

10278 Issued in KY

Practice address

1250 Patrol Rd
Charlestown, IN 47111-8670

Phone

(812) 406-2299

Fax

(812) 406-2299

NPI assigned

Sep 9, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567987200000",
    "number": "1003465451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 PATROL RD",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471118670",
            "telephone_number": "812-406-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 PATROL RD",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471118670",
            "telephone_number": "812-406-2299",
            "fax_number": "812-406-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUTHALL",
        "first_name": "PATRICK",
        "middle_name": "J",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "KY",
            "license": "10278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary E Smith, DMD
• Jennifer B Smith, NP
• Kristin Leah Smith, PHARMD
• Mark Smith
• SN Kentuckiana Rehab, LLC
• Southern Indiana Orthopedic & Spine Surgery, PSC
• Southern Indiana Treatment Center
• Southern Indiana Treatment Center
• Southern Indiana Treatment Center, LLC
• Southern Indiana Vision Associates, LLC

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Charlestown, IN
• Providers in Charlestown, IN by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.