Provider Demographics
NPI:1235889411
Name:BEAVERS, PEYTON DAVIS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:PEYTON
Middle Name:DAVIS
Last Name:BEAVERS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:PEYTON
Other - Middle Name:DEBORAH
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:800 ROSE ST RM H110
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-323-4756
Mailing Address - Fax:859-323-0069
Practice Address - Street 1:529 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3229
Practice Address - Country:US
Practice Address - Phone:502-562-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-28
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0228271835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology