Individual
DR. DAVID KETCHUM II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
946 E REED ST, HAYTI, MO 63851-1243
(573) 359-1372
(573) 359-3530
Mailing address
715 ANDREA DR, DYERSBURG, TN 38024-7195
(573) 359-1372
(573) 359-3530
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
045243
MO
183500000X
Pharmacist
10463
TN
1835P1200X
Pharmacotherapy Pharmacist
045243
MO
1835P1200X
Pharmacotherapy Pharmacist
10463
TN
Other
Enumeration date
03/03/2008
Last updated
02/22/2013
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