Provider Demographics
NPI:1235283813
Name:MCCAIG, CANDACE CLANTON (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:CANDACE
Middle Name:CLANTON
Last Name:MCCAIG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PREACHER DOWLAND RD
Mailing Address - Street 2:
Mailing Address - City:KENTON
Mailing Address - State:TN
Mailing Address - Zip Code:38233-3245
Mailing Address - Country:US
Mailing Address - Phone:731-673-4209
Mailing Address - Fax:731-665-6786
Practice Address - Street 1:114 E MAIN ST
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:TN
Practice Address - Zip Code:38369-9711
Practice Address - Country:US
Practice Address - Phone:731-665-6176
Practice Address - Fax:731-665-6786
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26656183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist