Provider Demographics
NPI:1154602811
Name:STILES, KRIS ROGER (RPH)
Entity type:Individual
Prefix:MISS
First Name:KRIS
Middle Name:ROGER
Last Name:STILES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 E VILLAGE CIRCLE DR S
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-4814
Mailing Address - Country:US
Mailing Address - Phone:602-828-3187
Mailing Address - Fax:602-344-6306
Practice Address - Street 1:850 E HATCHER RD
Practice Address - Street 2:PHARMACY
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2693
Practice Address - Country:US
Practice Address - Phone:602-216-1473
Practice Address - Fax:602-216-1467
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS007758183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist