MEDICARE: JOHN M. KORNET

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	011508	KY

General Provider Information

NPI Number	:	1518257088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN M. KORNET

Provider Business Mailing Address
First Line	:	3444 KEITHSHIRE WAY
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40503-4109
Country	:	US
Telephone Number	:	859-223-9547
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 RICHMOND RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-1503
Country	:	US
Telephone Number	:	859-269-5396
Fax Number	:	859-269-1028

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

Provider Enumeration Date	:	04/18/2011
Last Update Date	:	04/18/2011

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