Healthcare Provider Details

I. General information

NPI: 1689602203
Provider Name (Legal Business Name): TRACY S. ENGLISH RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 E LOUISE ST
CLARKESVILLE GA
30523-6019
US

IV. Provider business mailing address

184 PAUL FRANKLIN RD
CLARKESVILLE GA
30523-6606
US

V. Phone/Fax

Practice location:
  • Phone: 706-754-3933
  • Fax: 706-754-3974
Mailing address:
  • Phone: 706-754-5570
  • Fax: 706-754-5570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number017306
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: