Healthcare Provider Details

I. General information

NPI: 1336067214
Provider Name (Legal Business Name): TYLER WEIR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W EVERLY BROTHERS BLVD
CENTRAL CITY KY
42330-1833
US

IV. Provider business mailing address

300 HAMBY AVE
DAWSON SPRINGS KY
42408-1808
US

V. Phone/Fax

Practice location:
  • Phone: 270-754-3924
  • Fax:
Mailing address:
  • Phone: 270-871-9287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number025851
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: