Basic Information
| Provider Information | |||||||||
| NPI: | 1033717822 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PUTERBAUGH | ||||||||
| FirstName: | JULIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 617 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ELKTON | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422208815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8592242369 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1213 SKYLINE DR | ||||||||
| Address2: | |||||||||
| City: | HOPKINSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 422404986 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2708864594 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2020 | ||||||||
| LastUpdateDate: | 10/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1835P0018X | 021547 | KY | Y | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
No ID Information.