Healthcare Provider Details

I. General information

NPI: 1720399918
Provider Name (Legal Business Name): JAMES MATTHEW HEGARTY PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2010
Last Update Date: 06/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N HALL RD
ALCOA TN
37701-2518
US

IV. Provider business mailing address

225 N HALL RD
ALCOA TN
37701-2518
US

V. Phone/Fax

Practice location:
  • Phone: 865-982-2463
  • Fax: 865-982-5331
Mailing address:
  • Phone: 865-982-2463
  • Fax: 865-982-5331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0000030992
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: