Provider Demographics
NPI:1275829913
Name:ATKINSON, DEE W (PHARMD)
Entity Type:Individual
Prefix:
First Name:DEE
Middle Name:W
Last Name:ATKINSON
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 1:490 N 2ND E
Mailing Address - Street 2:
Mailing Address - City:REXBURG
Mailing Address - State:ID
Mailing Address - Zip Code:83440-1654
Mailing Address - Country:US
Mailing Address - Phone:208-542-2088
Mailing Address - Fax:208-542-2089
Practice Address - Street 1:490 N 2ND E
Practice Address - Street 2:
Practice Address - City:REXBURG
Practice Address - State:ID
Practice Address - Zip Code:83440-1654
Practice Address - Country:US
Practice Address - Phone:208-542-2088
Practice Address - Fax:208-542-2089
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP5906183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist