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General NPI Number Information
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NPI Number | 1790287852
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Entity Type | Individual
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Provider Name | GARY L NEIGHBORS
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Gender | Male
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Dates
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Enumeration Date | 03/05/2018
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Last Update Date | 03/05/2018
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Provider Practice Location Address
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Address Line | 5764 HIGHWAY 153
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City | HIXSON
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State | TN
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Zip | 37343-3727
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Country | US
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Telephone | 423-870-3267
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Fax | 423-870-1622
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Provider Business Mailing Address
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Address Line | 504 BRIAR PARK LN
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City | HIXSON
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State | TN
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Zip | 37343-3823
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Country | US
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Telephone | 423-870-1726
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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 | 168
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License Number State | TN
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