Provider Demographics
NPI:1790168664
Name:MURDOCK, DONALD KEITH (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:KEITH
Last Name:MURDOCK
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 FORBES LOOP
Mailing Address - Street 2:
Mailing Address - City:GRANDY
Mailing Address - State:NC
Mailing Address - Zip Code:27939-9625
Mailing Address - Country:US
Mailing Address - Phone:252-453-8500
Mailing Address - Fax:252-453-3051
Practice Address - Street 1:123 FORBES LOOP
Practice Address - Street 2:
Practice Address - City:GRANDY
Practice Address - State:NC
Practice Address - Zip Code:27939-9625
Practice Address - Country:US
Practice Address - Phone:252-453-8500
Practice Address - Fax:252-453-3051
Is Sole Proprietor?:No
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16596183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist