Healthcare Provider Details

I. General information

NPI: 1396960266
Provider Name (Legal Business Name): ROBERT L. PARKERSON D.PH., BCPS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N STATE OF FRANKLIN RD PHARMACY SERVICES
JOHNSON CITY TN
37604-6035
US

IV. Provider business mailing address

719 FERNDALE RD
JOHNSON CITY TN
37604-2414
US

V. Phone/Fax

Practice location:
  • Phone: 423-431-6860
  • Fax: 423-431-5564
Mailing address:
  • Phone: 423-431-6860
  • Fax: 423-431-5564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number1500
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: