Provider Demographics
NPI:1629140272
Name:WITT, JOHN MICHEAL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHEAL
Last Name:WITT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5300 SPEAKER RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66106-1050
Mailing Address - Country:US
Mailing Address - Phone:913-573-1237
Mailing Address - Fax:913-551-8504
Practice Address - Street 1:5300 SPEAKER RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66106-1050
Practice Address - Country:US
Practice Address - Phone:913-573-1237
Practice Address - Fax:913-551-8504
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13239183500000X
MO045247183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist