Provider Demographics
NPI:1215239876
Name:WILLIAMS, KENDEL NEIL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KENDEL
Middle Name:NEIL
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:NC
Mailing Address - Zip Code:27239-8913
Mailing Address - Country:US
Mailing Address - Phone:336-859-4572
Mailing Address - Fax:336-859-0418
Practice Address - Street 1:310 VERNON AVE
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:NC
Practice Address - Zip Code:27239-8913
Practice Address - Country:US
Practice Address - Phone:336-859-4572
Practice Address - Fax:336-859-0418
Is Sole Proprietor?:No
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12298183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist