Provider Demographics
NPI:1619565413
Name:MULLINS, KYLE B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KYLE
Middle Name:B
Last Name:MULLINS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:180 TOWN MOUNTAIN RD STE 115
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-1645
Mailing Address - Country:US
Mailing Address - Phone:606-437-7333
Mailing Address - Fax:606-432-3233
Practice Address - Street 1:180 TOWN MOUNTAIN RD STE 115
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1645
Practice Address - Country:US
Practice Address - Phone:606-437-7333
Practice Address - Fax:606-432-3233
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY015256183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist