Provider Demographics
NPI:1619352853
Name:KAYLOR, JOHN EDWARD (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:EDWARD
Last Name:KAYLOR
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 1:5041 TIMBERLINE LN
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-7111
Mailing Address - Country:US
Mailing Address - Phone:704-854-9325
Mailing Address - Fax:
Practice Address - Street 1:5041 TIMBERLINE LN
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-7111
Practice Address - Country:US
Practice Address - Phone:704-854-9325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist