Provider Demographics
NPI:1093327512
Name:GREGORY, WILLIAM TAYLOR (PHARMD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:TAYLOR
Last Name:GREGORY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:TAYLOR
Other - Last Name:GREGORY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:105 KENSINGTON LN
Mailing Address - Street 2:
Mailing Address - City:TULLAHOMA
Mailing Address - State:TN
Mailing Address - Zip Code:37388-4849
Mailing Address - Country:US
Mailing Address - Phone:931-247-0968
Mailing Address - Fax:
Practice Address - Street 1:305 LEMMON DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-6746
Practice Address - Country:US
Practice Address - Phone:931-247-0968
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist