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Individual

DR. KARL RAY DEIBEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD, BCPS

Contact information

Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 562-3436
Mailing address
7304 MEADOW RD, CRESTWOOD, KY 40014-9453
(502) 241-1013

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
012703
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
012703
KY PHARMACY LICENSE
KY
Enumeration date
01/04/2007
Last updated
07/08/2007
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