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Individual

JOHN LEVER ROBERTSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
538 LONE OAK RD, PADUCAH, KY 42003-4538
(270) 443-8855
Mailing address
3950 PHILLIPS AVE, PADUCAH, KY 42001-4648
(270) 519-4944

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
008562
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
008562
PHARMACIST LICENSE
KY
Enumeration date
11/18/2020
Last updated
11/18/2020
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