Provider Demographics
NPI:1407822356
Name:DUNLAP, ANTHONY BLAKE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:BLAKE
Last Name:DUNLAP
Suffix:
Gender:M
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:PO BOX 4438
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841
Mailing Address - Country:US
Mailing Address - Phone:423-569-5555
Mailing Address - Fax:423-569-8805
Practice Address - Street 1:18157 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-6201
Practice Address - Country:US
Practice Address - Phone:423-569-5555
Practice Address - Fax:423-569-8805
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist