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NPI Code Detail

MEDICARE: DR. DWIGHT KEITH PERKINS PHARM.D.

MEDICARE: DR. DWIGHT KEITH PERKINS PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist1-12713KS
2183500000XPharmacist041611MO

General Provider Information

NPI Number : 1083615769
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DWIGHT KEITH PERKINS PHARM.D.
Provider Business Mailing Address
First Line : 319 NE WARRINGTON CT
Second Line :
City : LEES SUMMIT
State : MO
Zip : 64064-1605
Country : US
Telephone Number : 816-478-1349
Fax Number :
Provider Business Practice Location Address
First Line : 9100 W 74TH ST
Second Line : SMMC - PHARMACY
City : MERRIAM
State : KS
Zip : 66204-4004
Country : US
Telephone Number : 913-676-8106
Fax Number : 913-789-3175
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 07/08/2007

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