Healthcare Provider Details

I. General information

NPI: 1457758781
Provider Name (Legal Business Name): DEREK PHILLIPS PHARMD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2014
Last Update Date: 06/01/2021
Certification Date: 06/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2018 CLINCH AVE
KNOXVILLE TN
37916-2301
US

IV. Provider business mailing address

1111 DELRAY RD
KNOXVILLE TN
37923-2094
US

V. Phone/Fax

Practice location:
  • Phone: 865-541-8980
  • Fax: 865-541-8429
Mailing address:
  • Phone: 404-660-3135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH027843
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number44660
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: