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General NPI Number Information
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NPI Number | 1508957606
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Entity Type | Individual
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Provider Name | JAMES STEVEN TALLENT
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 07/24/2009
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Provider Practice Location Address
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Address Line | 4249 HIGHWAY 411 UNIT 5
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City | MADISONVILLE
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State | TN
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Zip | 37354-1544
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Country | US
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Telephone | 423-442-9727
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Fax | 423-442-5057
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Provider Business Mailing Address
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Address Line | 104 SHANNADOAH LN
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City | MADISONVILLE
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State | TN
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Zip | 37354-5380
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Country | US
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Telephone | 423-442-5265
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Fax | 423-442-5057
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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 | 4957
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License Number State | TN
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