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General NPI Number Information
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NPI Number | 1881256303
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Entity Type | Individual
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Provider Name | KENDALL DAVID HYATT PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/04/2019
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Last Update Date | 07/04/2019
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Provider Practice Location Address
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Address Line | 3721 NEW MACLAND RD STE 300
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-2088
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Country | US
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Telephone | 770-222-2778
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Fax |
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Provider Business Mailing Address
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Address Line | 2047 LAKE PARK DR SE APT L
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City | SMYRNA
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State | GA
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Zip | 30080-7678
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Country | US
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Telephone | 706-302-0226
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Fax |
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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 | RPH031347
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License Number State | GA
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