Provider Demographics
NPI:1275844433
Name:ROBERTS, PEYTON NOBLE (RPH)
Entity Type:Individual
Prefix:MR
First Name:PEYTON
Middle Name:NOBLE
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 VOLUNTEER BLVD STE 134
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996-4522
Mailing Address - Country:US
Mailing Address - Phone:865-974-5932
Mailing Address - Fax:865-974-5935
Practice Address - Street 1:1800 VOLUNTEER BLVD STE 134
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-4522
Practice Address - Country:US
Practice Address - Phone:865-974-5932
Practice Address - Fax:865-974-5935
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12001183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist