Provider Demographics
NPI:1194226381
Name:GOUVION, JOEL ARNOLD (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:ARNOLD
Last Name:GOUVION
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 1:458 N BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:KS
Mailing Address - Zip Code:67037-1606
Mailing Address - Country:US
Mailing Address - Phone:316-788-4317
Mailing Address - Fax:316-788-6859
Practice Address - Street 1:458 N BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:KS
Practice Address - Zip Code:67037-1606
Practice Address - Country:US
Practice Address - Phone:316-788-4317
Practice Address - Fax:316-788-6859
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-102992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist