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General NPI Number Information
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NPI Number | 1265441984
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Entity Type | Individual
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Provider Name | ROBERT WAYNE BULLINGTON PHARM D
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 524 ANDREW JOHNSON HWY
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City | STRAWBERRY PLAINS
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State | TN
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Zip | 37871-1015
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Country | US
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Telephone | 865-933-4149
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Fax | 865-933-4037
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Provider Business Mailing Address
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Address Line | 514 DEER TRACE WAY
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City | SEYMOUR
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State | TN
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Zip | 37865-6061
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Country | US
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Telephone | 901-355-5556
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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 | 21803
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License Number State | TN
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