Provider Demographics
NPI:1679881247
Name:GOVINDARAJAN, KARTHIKEYAN (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:KARTHIKEYAN
Middle Name:
Last Name:GOVINDARAJAN
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 1:3832 E SPEEDWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-4039
Mailing Address - Country:US
Mailing Address - Phone:520-323-3923
Mailing Address - Fax:520-323-3923
Practice Address - Street 1:3832 E SPEEDWAY BLVD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-4039
Practice Address - Country:US
Practice Address - Phone:520-323-3923
Practice Address - Fax:520-323-3923
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS016207183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist