Provider Demographics
NPI:1972148849
Name:WELTY, KENDAL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KENDAL
Middle Name:
Last Name:WELTY
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 1:3101 BEAUMONT CENTRE CIRCLE
Mailing Address - Street 2:SUITE 160 ROOM 135
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1987
Mailing Address - Country:US
Mailing Address - Phone:859-562-0220
Mailing Address - Fax:859-323-0135
Practice Address - Street 1:3101 BEAUMONT CENTRE CIRCLE
Practice Address - Street 2:SUITE 160 ROOM 135
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40513-1987
Practice Address - Country:US
Practice Address - Phone:859-562-0220
Practice Address - Fax:859-323-0135
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY020833183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist