Provider Demographics
NPI:1184756066
Name:MCMAHAN, MATTHEW EDWARD (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:EDWARD
Last Name:MCMAHAN
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 1:560 ALBANY RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40502-2935
Mailing Address - Country:US
Mailing Address - Phone:859-278-7833
Mailing Address - Fax:
Practice Address - Street 1:115 SCOVELL HALL
Practice Address - Street 2:UNIVERSITY OF KENTUCKY
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40506-0064
Practice Address - Country:US
Practice Address - Phone:859-257-2154
Practice Address - Fax:859-323-1095
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8731183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist