Healthcare Provider Details

I. General information

NPI: 1518041516
Provider Name (Legal Business Name): ROBERT YOWLER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 HWY. 42 EAST
BEDFORD KY
40006
US

IV. Provider business mailing address

PO BOX 243
BEDFORD KY
40006-0243
US

V. Phone/Fax

Practice location:
  • Phone: 502-255-3540
  • Fax: 502-255-3615
Mailing address:
  • Phone: 502-255-3540
  • Fax: 502-255-3615

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number18D0950636
License Number StateKY

VIII. Authorized Official

Name: MR. ROBERT PARKER YOWLER II
Title or Position: OWNER
Credential: R.PH.
Phone: 502-255-3540