Provider Demographics
NPI:1710194956
Name:WATKINS, DENNIS WILLIAM (RPH)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:WILLIAM
Last Name:WATKINS
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 1:6028 N SPRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-5314
Mailing Address - Country:US
Mailing Address - Phone:816-455-3909
Mailing Address - Fax:816-455-3909
Practice Address - Street 1:6028 N SPRUCE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-5314
Practice Address - Country:US
Practice Address - Phone:816-455-3909
Practice Address - Fax:816-455-3909
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO028182183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist