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General NPI Number Information
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NPI Number | 1639917594
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Entity Type | Individual
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Provider Name | GRAYSON ROUNTREE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/16/2024
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 9225 KINGSTON PIKE
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City | KNOXVILLE
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State | TN
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Zip | 37922-2303
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Country | US
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Telephone | 865-985-7970
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Fax |
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Provider Business Mailing Address
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Address Line | 2506 WILD TIMBER WAY
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City | KNOXVILLE
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State | TN
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Zip | 37931-2421
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Country | US
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Telephone | 423-244-1228
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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 | 48153
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License Number State | TN
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