Healthcare Provider Details

I. General information

NPI: 1033417696
Provider Name (Legal Business Name): DAVID RANDALL MARTIN PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2011
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4409 CHAPMAN HWY
KNOXVILLE TN
37920-4366
US

IV. Provider business mailing address

10805 KINGSTON PIKE STE 100
KNOXVILLE TN
37934-3040
US

V. Phone/Fax

Practice location:
  • Phone: 865-573-9906
  • Fax:
Mailing address:
  • Phone: 865-801-5632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number34265
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: