Provider Demographics
NPI:1356687172
Name:KHO, DAVID YONG (PHARMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:YONG
Last Name:KHO
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 1:719 COURTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-2762
Mailing Address - Country:US
Mailing Address - Phone:404-429-6669
Mailing Address - Fax:
Practice Address - Street 1:3204 PEACH ORCHARD RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-4862
Practice Address - Country:US
Practice Address - Phone:706-796-7240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA026815183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist