Provider Demographics
NPI:1790725000
Name:KECK, WILLIAM A III (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:A
Last Name:KECK
Suffix:III
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 1:42 EMERALD DR
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-7426
Mailing Address - Country:US
Mailing Address - Phone:606-528-8505
Mailing Address - Fax:
Practice Address - Street 1:42 EMERALD DR
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-7426
Practice Address - Country:US
Practice Address - Phone:606-528-8505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY008026183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist