Provider Demographics
NPI:1083299291
Name:MCCLATCHEY, TYLER WILLIAM (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:TYLER
Middle Name:WILLIAM
Last Name:MCCLATCHEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 MOUNTAIN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5155
Mailing Address - Country:US
Mailing Address - Phone:517-404-2957
Mailing Address - Fax:
Practice Address - Street 1:1104 ROSA PARKS BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208
Practice Address - Country:US
Practice Address - Phone:615-244-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44435183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist