Provider Demographics
NPI:1376921205
Name:TUMLIN, MATTHEW DUKE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DUKE
Last Name:TUMLIN
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 1:2020 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-5027
Mailing Address - Country:US
Mailing Address - Phone:423-384-8970
Mailing Address - Fax:423-246-9259
Practice Address - Street 1:2020 CANTERBURY RD
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-5027
Practice Address - Country:US
Practice Address - Phone:423-384-8970
Practice Address - Fax:423-246-9259
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38538183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist