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General NPI Number Information
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NPI Number | 1952423378
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Entity Type | Individual
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Provider Name | KENNETH DONALD GEORGE R PH
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Gender | Male
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Dates
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Enumeration Date | 04/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1490 CHESNUT BYP
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City | CENTRE
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State | AL
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Zip | 35960-2815
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Country | US
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Telephone | 256-927-8539
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Fax | 256-927-8588
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Provider Business Mailing Address
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Address Line | 870 COUNTY ROAD 449
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City | CENTRE
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State | AL
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Zip | 35960-6828
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Country | US
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Telephone | 256-927-5427
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Fax | 256-927-8588
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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 | 7048
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License Number State | AL
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