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General NPI Number Information
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NPI Number | 1972527307
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Entity Type | Individual
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Provider Name | MORRIS J MATZKE RPH
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Gender | Male
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 320 W 18TH ST
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-1965
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Country | US
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Telephone | 270-887-0166
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Fax |
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Provider Business Mailing Address
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Address Line | 1113 BLACK OAK LN
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City | HOPKINSVILLE
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State | KY
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Zip | 42240-5161
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Country | US
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Telephone | 270-886-9530
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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 | 6790
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License Number State | KY
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