Provider Demographics
NPI:1174905129
Name:SAWYER, RYAN (PHARMD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:SAWYER
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 1:2713 BRADEN WAY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-8572
Mailing Address - Country:US
Mailing Address - Phone:740-525-0319
Mailing Address - Fax:
Practice Address - Street 1:300 KROGER CTR
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-8895
Practice Address - Country:US
Practice Address - Phone:606-783-1476
Practice Address - Fax:606-780-9484
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY017823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist