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Individual
DR. TYLER ANTHONY FREDERICK
Active
Individual
DR. TYLER ANTHONY FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
020737
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020737
KENTUCKY BOARD OF PHARMACY
KY
01
—
F11-171-186
KENTUCKY DRIVER'S LICENSE
KY
Enumeration date
11/01/2019
Last updated
06/24/2026
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