Provider Demographics
NPI:1124701982
Name:WRIGHT, JOHN TYLER (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:TYLER
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 WHITE TAIL CIR
Mailing Address - Street 2:
Mailing Address - City:SHEPHERDSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40165-7413
Mailing Address - Country:US
Mailing Address - Phone:502-777-9165
Mailing Address - Fax:
Practice Address - Street 1:311 WHITE TAIL CIR
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-7413
Practice Address - Country:US
Practice Address - Phone:502-777-9165
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY022983183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist