Provider Demographics
NPI:1346548666
Name:DUNN, WILLIAM ROGER (RPH)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ROGER
Last Name:DUNN
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 1:1376 SOUTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-3932
Mailing Address - Country:US
Mailing Address - Phone:864-953-2251
Mailing Address - Fax:864-953-9611
Practice Address - Street 1:1376 S MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-3932
Practice Address - Country:US
Practice Address - Phone:864-953-2251
Practice Address - Fax:864-953-9611
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist