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General NPI Number Information
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NPI Number | 1033764436
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Entity Type | Individual
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Provider Name | JAMES THOMAS BAILEY III DPH
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Gender | Male
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Dates
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Enumeration Date | 08/03/2019
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Last Update Date | 08/03/2019
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Provider Practice Location Address
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Address Line | 7565 DANNAHER DR
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City | POWELL
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State | TN
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Zip | 37849-4029
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Country | US
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Telephone | 865-859-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 661 N EAST END RD
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City | STRAWBERRY PLAINS
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State | TN
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Zip | 37871-1439
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Country | US
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Telephone | 865-207-6913
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0000000477
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License Number State | TN
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