Provider Demographics
NPI:1245317098
Name:WHITAKER, STEVE E (RPH)
Entity type:Individual
Prefix:MR
First Name:STEVE
Middle Name:E
Last Name:WHITAKER
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 1:644 N MAYSVILLE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353
Mailing Address - Country:US
Mailing Address - Phone:859-498-3141
Mailing Address - Fax:859-498-2434
Practice Address - Street 1:644 N MAYSVILLE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353
Practice Address - Country:US
Practice Address - Phone:859-498-3141
Practice Address - Fax:859-498-2434
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY010286183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY010286OtherPHARMACIST LICENSE NUMBER