Wylie Ray Clayton Sr.
Individual provider Active NPI Pharmacist · Cynthiana, KY
NPI 1669765277 · NPPES record last updated May 16, 2011
Key facts
- NPI
- 1669765277
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 6503 (KY)
- Practice address
- 1063 Ky Highway 36 E
Cynthiana, KY 41031-7584 - Phone
- (859) 234-5758
- NPI assigned
- May 16, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 6503 | KY | Yes |
Addresses
Primary practice location
1063 Ky Highway 36 E
Cynthiana, KY 41031-7584
Mailing address
1063 Ky Highway 36 E
Cynthiana, KY 41031-7584
Phone (859) 234-5758
Other providers in Cynthiana, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2011. 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.