Provider Demographics
NPI:1346357993
Name:CARTER, DAVID WAYNE (PHARMD, RPH, PD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WAYNE
Last Name:CARTER
Suffix:
Gender:M
Credentials:PHARMD, RPH, PD
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 92
Mailing Address - Street 2:
Mailing Address - City:CHETOPA
Mailing Address - State:KS
Mailing Address - Zip Code:67336-0092
Mailing Address - Country:US
Mailing Address - Phone:620-236-7812
Mailing Address - Fax:620-236-7395
Practice Address - Street 1:330 LOCUST
Practice Address - Street 2:
Practice Address - City:CHETOPA
Practice Address - State:KS
Practice Address - Zip Code:67336
Practice Address - Country:US
Practice Address - Phone:620-236-7272
Practice Address - Fax:620-236-7395
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13008183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist