Provider Demographics
NPI:1538450093
Name:HOLYFIELD, JOHN SHERMAN III (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SHERMAN
Last Name:HOLYFIELD
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1101
Mailing Address - Street 2:
Mailing Address - City:JENKINS
Mailing Address - State:KY
Mailing Address - Zip Code:41537-1101
Mailing Address - Country:US
Mailing Address - Phone:606-821-5916
Mailing Address - Fax:
Practice Address - Street 1:102 VILLAGE LN
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9408
Practice Address - Country:US
Practice Address - Phone:606-435-2363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2022-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist