Provider Demographics
NPI:1588635858
Name:WHYSONG, DAVID N (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:N
Last Name:WHYSONG
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 1:257 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:SCHELLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15559
Mailing Address - Country:US
Mailing Address - Phone:814-733-2550
Mailing Address - Fax:
Practice Address - Street 1:4186 CORTLAND DR
Practice Address - Street 2:
Practice Address - City:NEW PARIS
Practice Address - State:PA
Practice Address - Zip Code:15554-0377
Practice Address - Country:US
Practice Address - Phone:814-839-9997
Practice Address - Fax:814-839-9955
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040968L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARP040968LOtherCOMM OF PA