Provider Demographics
NPI:1336474550
Name:EMMONS, JOHN T (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:EMMONS
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 1:224 HANNA TODD PL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-9026
Mailing Address - Country:US
Mailing Address - Phone:859-523-9124
Mailing Address - Fax:
Practice Address - Street 1:224 HANNA TODD PL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-9026
Practice Address - Country:US
Practice Address - Phone:859-523-9124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013358183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist