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NPI Code Detail

MEDICARE: DONALD BUFORD HERRON III PHARMD

MEDICARE: DONALD BUFORD HERRON III PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist47381TN

General Provider Information

NPI Number : 1659134294
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD BUFORD HERRON III PHARMD
Provider Business Mailing Address
First Line : 920 N STATE OF FRANKLIN RD
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-3668
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 920 N STATE OF FRANKLIN RD
Second Line :
City : JOHNSON CITY
State : TN
Zip : 37604-3668
Country : US
Telephone Number : 423-232-9015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2024
Last Update Date : 02/05/2024

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