David Axt, PHARMD
Individual provider Active NPI Pharmacotherapy Pharmacist · Bowler, WI
NPI 1811067754 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1811067754
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacotherapy Pharmacist 1835P1200X
- License
- 10049-040 (WI)
- Practice address
- W12802 County Highway a
Bowler, WI 54416-0086 - Phone
- (715) 793-5074
- Fax
- (715) 793-5074
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10049-040 | WI | MD | Pharmacotherapy Pharmacist |
Interoperability endpoints
- daxt@lcohc.directbygreenway.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 10049-040 | WI | Yes |
Addresses
Primary practice location
W12802 County Highway a
Bowler, WI 54416-0086
Mailing address
W12802 County Highway a
Bowler, WI 54416-0086
Other providers in Bowler, WI
All providers in Bowler, WI · Pharmacotherapy Pharmacist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.