Provider Demographics
NPI:1568842870
Name:DUNFORD, KAYLA (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:DUNFORD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BECKLEY PLZ
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-2215
Mailing Address - Country:US
Mailing Address - Phone:276-206-0202
Mailing Address - Fax:
Practice Address - Street 1:301 BECKLEY PLZ
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2215
Practice Address - Country:US
Practice Address - Phone:276-206-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0008234183500000X
VA0202212413183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist