Provider Demographics
NPI:1598772097
Name:WHITTINGTON, RODNEY PIERCE (RPH)
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:PIERCE
Last Name:WHITTINGTON
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 1:307 CEDAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:KY
Mailing Address - Zip Code:42445-2344
Mailing Address - Country:US
Mailing Address - Phone:270-365-6717
Mailing Address - Fax:270-365-0559
Practice Address - Street 1:103 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:KY
Practice Address - Zip Code:42445-1546
Practice Address - Country:US
Practice Address - Phone:270-365-5585
Practice Address - Fax:270-365-0559
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6371183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY54000690Medicaid
KY54000690Medicaid