Provider Demographics
NPI:1043365828
Name:COMPEAUX, MICHAEL PAUL (RPH)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:PAUL
Last Name:COMPEAUX
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 1:3906 E. ROCKWOOD DR.
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-3282
Mailing Address - Country:US
Mailing Address - Phone:504-982-9095
Mailing Address - Fax:504-849-6901
Practice Address - Street 1:3906 E. ROCKWOOD DR.
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-3282
Practice Address - Country:US
Practice Address - Phone:504-982-9095
Practice Address - Fax:504-849-6901
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051-040252183500000X
TX32145183500000X
NJ23605183500000X
GA017148183500000X
FLPS 31216183500000X
LA16832183500000X
GARPH017148183500000X
FLPU8521183500000X
IL051040252183500000X
AZSO16944183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist