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General NPI Number Information
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NPI Number | 1700222007
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Entity Type | Individual
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Provider Name | MARY BLANTON WHEELER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 1000 S LIMESTONE
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City | LEXINGTON
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State | KY
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Zip | 40503-1072
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Country | US
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Telephone | 859-583-3849
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Fax |
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Provider Business Mailing Address
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Address Line | 505 BROOK FARM CT
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City | LEXINGTON
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State | KY
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Zip | 40517-2038
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Country | US
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Telephone | 859-583-3849
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 015976
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License Number State | KY
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