Provider Demographics
NPI:1710576210
Name:HUNTINGTON, DOUGLAS KAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:KAY
Last Name:HUNTINGTON
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:PO BOX 1225
Mailing Address - Street 2:
Mailing Address - City:PAROWAN
Mailing Address - State:UT
Mailing Address - Zip Code:84761-1225
Mailing Address - Country:US
Mailing Address - Phone:435-477-3000
Mailing Address - Fax:435-477-8605
Practice Address - Street 1:20 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PAROWAN
Practice Address - State:UT
Practice Address - Zip Code:84761-7707
Practice Address - Country:US
Practice Address - Phone:435-477-3000
Practice Address - Fax:435-477-8605
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6146966-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist