Provider Demographics
NPI:1043725369
Name:BOATWRIGHT, DANIEL WESSTON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:WESSTON
Last Name:BOATWRIGHT
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 1:1557 AIKEN CHAFIN LN
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30252-4002
Mailing Address - Country:US
Mailing Address - Phone:904-891-3175
Mailing Address - Fax:
Practice Address - Street 1:1557 AIKEN CHAFIN LN
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30252-4002
Practice Address - Country:US
Practice Address - Phone:904-891-3175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-08
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS256971835C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0205XPharmacy Service ProvidersPharmacistCritical Care