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General NPI Number Information
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NPI Number | 1871621250
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Entity Type | Individual
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Provider Name | MARSHALL CLAY COMBS DPH
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Gender | Male
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 03/17/2011
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Provider Practice Location Address
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Address Line | 1735 W STATE OF FRANKLIN RD
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6573
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Country | US
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Telephone | 423-929-2611
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Fax | 423-929-8301
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Provider Business Mailing Address
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Address Line | 405 CHRISTIAN CHURCH RD APT 41
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City | JOHNSON CITY
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State | TN
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Zip | 37615-4584
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Country | US
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Telephone | 865-696-5567
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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 | C-5636
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License Number State | TN
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