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General NPI Number Information
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NPI Number | 1013215227
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Entity Type | Individual
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Provider Name | KIMBERLY P DUCKWORTH RPH
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Gender | Female
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 377 FURYS FERRY RD
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City | MARTINEZ
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State | GA
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Zip | 30907-3047
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Country | US
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Telephone | 706-854-0608
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Fax |
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Provider Business Mailing Address
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Address Line | 3491 STALLINGS ISLAND RD
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City | MARTINEZ
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State | GA
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Zip | 30907-9410
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Country | US
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Telephone | 706-863-2113
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Fax | 706-869-0014
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13550
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License Number State | GA
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