MEDICARE: MR. JOHN P NIXON PHARMACIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	11636	KY

General Provider Information

NPI Number	:	1033227103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN P NIXON PHARMACIST

Provider Business Mailing Address
First Line	:	1513 EDMONTON RD
Second Line	:
City	:	TOMPKINSVILLE
State	:	KY
Zip	:	42167-9402
Country	:	US
Telephone Number	:	270-487-6155
Fax Number	:

Provider Business Practice Location Address
First Line	:	1513 EDMONTON RD
Second Line	:
City	:	TOMPKINSVILLE
State	:	KY
Zip	:	42167-9402
Country	:	US
Telephone Number	:	270-487-6155
Fax Number	:	270-487-6157

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	07/13/2021

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