Provider Demographics
NPI:1467534503
Name:AUSTIN, DOUGLAS F (DPH)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:F
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 WEST MARKET
Mailing Address - Street 2:SUITE 103 CO HILLCREST DRUG
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-5483
Mailing Address - Country:US
Mailing Address - Phone:423-926-6231
Mailing Address - Fax:423-926-0084
Practice Address - Street 1:714 WEST MARKET ST
Practice Address - Street 2:SUITE 103 CO HILLCREST DRUG
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-5483
Practice Address - Country:US
Practice Address - Phone:423-926-6231
Practice Address - Fax:423-926-6231
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC7964183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist