Provider Demographics
NPI:1427492933
Name:WENZL, ROBERT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:WENZL
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 1:300 STATE ST
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:67661-1930
Mailing Address - Country:US
Mailing Address - Phone:785-543-5131
Mailing Address - Fax:785-543-5844
Practice Address - Street 1:300 STATE ST
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:KS
Practice Address - Zip Code:67661-1930
Practice Address - Country:US
Practice Address - Phone:785-543-5131
Practice Address - Fax:785-543-5844
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-13642183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist