Provider Demographics
NPI:1235213505
Name:OVERTON, DENNY BRUCE (RPH)
Entity Type:Individual
Prefix:MR
First Name:DENNY
Middle Name:BRUCE
Last Name:OVERTON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 712
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40977
Mailing Address - Country:US
Mailing Address - Phone:606-337-9836
Mailing Address - Fax:606-337-0820
Practice Address - Street 1:123 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:KY
Practice Address - Zip Code:40977-1619
Practice Address - Country:US
Practice Address - Phone:606-337-3041
Practice Address - Fax:606-337-0820
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist