Provider Demographics
NPI:1275660318
Name:ESSARY, RUSSELL (PHARMD)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:
Last Name:ESSARY
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:PO BOX 1438
Mailing Address - Street 2:
Mailing Address - City:NEW TAZEWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37824-1438
Mailing Address - Country:US
Mailing Address - Phone:423-626-7337
Mailing Address - Fax:423-626-0189
Practice Address - Street 1:420 N BROAD ST
Practice Address - Street 2:
Practice Address - City:NEW TAZEWELL
Practice Address - State:TN
Practice Address - Zip Code:37825-6606
Practice Address - Country:US
Practice Address - Phone:423-626-7337
Practice Address - Fax:423-626-0189
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist