Provider Demographics
NPI:1225034606
Name:FLYNN, JEREMY D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:D
Last Name:FLYNN
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 1:4029 BOONE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-9711
Mailing Address - Country:US
Mailing Address - Phone:859-263-7566
Mailing Address - Fax:
Practice Address - Street 1:UKCMC 800 ROSE STREET
Practice Address - Street 2:ROOM C-117
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0293
Practice Address - Country:US
Practice Address - Phone:859-323-0076
Practice Address - Fax:859-323-2049
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011891183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist