Provider Demographics
NPI:1881171874
Name:FLAUGHER, TYLER JACOB (PHARMD)
Entity type:Individual
Prefix:
First Name:TYLER
Middle Name:JACOB
Last Name:FLAUGHER
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 1:56 STATE HIGHWAY 1122
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:KY
Mailing Address - Zip Code:41143-6800
Mailing Address - Country:US
Mailing Address - Phone:859-472-4246
Mailing Address - Fax:
Practice Address - Street 1:200 WALMART WAY
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351-7217
Practice Address - Country:US
Practice Address - Phone:606-784-3266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020070183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY020070OtherKY LICENSE NUMBER