Provider Demographics
NPI:1134897952
Name:COMPTON, DUSTON KORY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DUSTON
Middle Name:KORY
Last Name:COMPTON
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 1:2329 N GRAND AVE TRLR 9
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-9406
Mailing Address - Country:US
Mailing Address - Phone:412-735-3725
Mailing Address - Fax:
Practice Address - Street 1:2329 N GRAND AVE TRLR 9
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-9406
Practice Address - Country:US
Practice Address - Phone:412-735-3725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00009588183500000X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist