Individual
LOGAN KEITH ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1460 BLUEGRASS AVE, LOUISVILLE, KY 40215-1272
(573) 308-2374
Mailing address
529 S JACKSON ST, LOUISVILLE, KY 40202-3229
(502) 561-7423
(502) 561-7385
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
019515
KY
1835X0200X
Oncology Pharmacist
019515
KY
Other
Enumeration date
10/27/2022
Last updated
10/27/2022
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