Johnny Wayne Burkett, RPH
Individual provider Active NPI Pharmacist · Nortonville, KY
NPI 1265449706 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1265449706
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 006708 (KY)
- Practice address
- 102 Greenville Road
Nortonville, KY 42442 - Phone
- (270) 676-8268
- Fax
- (270) 676-8205
- NPI assigned
- Aug 1, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 006708 | KY | Yes |
Addresses
Primary practice location
102 Greenville Road
Nortonville, KY 42442
Mailing address
134 Ridgewood LN
Greenville, KY 42345-4562
Phone (270) 338-5764
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 006708 | Other | KY | KENTUCKY PHARMACIST LIC/ |
Other providers in Nortonville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.