Provider Demographics
NPI:1649557307
Name:PHIPPS, JOHN DARRELL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DARRELL
Last Name:PHIPPS
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 1:6617 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-2164
Mailing Address - Country:US
Mailing Address - Phone:859-342-7764
Mailing Address - Fax:859-342-0609
Practice Address - Street 1:6617 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2164
Practice Address - Country:US
Practice Address - Phone:859-342-7764
Practice Address - Fax:859-342-0609
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist