Provider Demographics
NPI:1053083196
Name:ATKINS, KENDALL ADCOCK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KENDALL
Middle Name:ADCOCK
Last Name:ATKINS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KENDALL
Other - Middle Name:ADCOCK
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:163 OAK GREEN DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-8706
Mailing Address - Country:US
Mailing Address - Phone:229-251-1345
Mailing Address - Fax:
Practice Address - Street 1:802 N HOUSTON RD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-1502
Practice Address - Country:US
Practice Address - Phone:478-923-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH033299183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist