Provider Demographics
NPI:1184228298
Name:STINSON, KEITH A (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:A
Last Name:STINSON
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 1:118 E NEW CIRCLE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-2115
Mailing Address - Country:US
Mailing Address - Phone:859-254-1326
Mailing Address - Fax:859-233-7393
Practice Address - Street 1:118 E NEW CIRCLE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-2115
Practice Address - Country:US
Practice Address - Phone:859-254-1326
Practice Address - Fax:859-233-7393
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist