Provider Demographics
NPI:1144783317
Name:MARSEE, MARTY RAY JR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARTY
Middle Name:RAY
Last Name:MARSEE
Suffix:JR
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 1:283 CREEKWOOD COVE LN APT 5B
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-6398
Mailing Address - Country:US
Mailing Address - Phone:423-494-7423
Mailing Address - Fax:
Practice Address - Street 1:111 S HALL RD
Practice Address - Street 2:
Practice Address - City:ALCOA
Practice Address - State:TN
Practice Address - Zip Code:37701-2639
Practice Address - Country:US
Practice Address - Phone:865-983-0573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN42395183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist