Provider Demographics
NPI:1912289281
Name:KEIGHLEY, DAVID JAMES (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JAMES
Last Name:KEIGHLEY
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 1:689 QUARRY RD
Mailing Address - Street 2:
Mailing Address - City:DUMMERSTON
Mailing Address - State:VT
Mailing Address - Zip Code:05301-9675
Mailing Address - Country:US
Mailing Address - Phone:802-257-0893
Mailing Address - Fax:
Practice Address - Street 1:225R KING ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2361
Practice Address - Country:US
Practice Address - Phone:413-587-2802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-13
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH24131183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist