Provider Demographics
NPI:1194214395
Name:ARNOLD, TRACY DWIGHT (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:DWIGHT
Last Name:ARNOLD
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 1:2150 COVINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38128-6907
Mailing Address - Country:US
Mailing Address - Phone:901-382-1616
Mailing Address - Fax:
Practice Address - Street 1:2150 COVINGTON PIKE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38128-6907
Practice Address - Country:US
Practice Address - Phone:901-382-1616
Practice Address - Fax:901-385-2857
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist