Provider Demographics
NPI:1588197529
Name:STECKLEIN, DOUGLAS (RPH)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:STECKLEIN
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 1:2505 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-2233
Mailing Address - Country:US
Mailing Address - Phone:785-625-2529
Mailing Address - Fax:785-625-8176
Practice Address - Street 1:2505 CANTERBURY DR
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-2233
Practice Address - Country:US
Practice Address - Phone:785-625-2529
Practice Address - Fax:785-625-8176
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-11842183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist