Provider Demographics
NPI:1508000928
Name:DUNEHEW, KIAH L (PHARM D)
Entity Type:Individual
Prefix:
First Name:KIAH
Middle Name:L
Last Name:DUNEHEW
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:KIAH
Other - Middle Name:L
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 895
Mailing Address - Street 2:
Mailing Address - City:WISTER
Mailing Address - State:OK
Mailing Address - Zip Code:74966-0895
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7434 ROGERS AVE
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5536
Practice Address - Country:US
Practice Address - Phone:479-452-0353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-29
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR10434183500000X
OK13941183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARPD10434OtherPHARMACY BOARD
OK13941OtherPHARMACY BOARD