Provider Demographics
NPI:1215255237
Name:DEFRATES, SEAN (PHARMD)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:DEFRATES
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 1:7308 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:MANITO
Mailing Address - State:IL
Mailing Address - Zip Code:61546-8221
Mailing Address - Country:US
Mailing Address - Phone:309-267-4240
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF KENTUCKY & AFFILIATES
Practice Address - Street 2:800 ROSE ST.
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-257-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program