Provider Demographics
NPI:1467580829
Name:CLAUSING, GARRY L (RPH)
Entity Type:Individual
Prefix:MR
First Name:GARRY
Middle Name:L
Last Name:CLAUSING
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 1:2666 ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:KODAK
Mailing Address - State:TN
Mailing Address - Zip Code:37764-1724
Mailing Address - Country:US
Mailing Address - Phone:865-484-0881
Mailing Address - Fax:865-484-0769
Practice Address - Street 1:123 WEST HWY 25-70
Practice Address - Street 2:
Practice Address - City:DANDRIDGE
Practice Address - State:TN
Practice Address - Zip Code:37725
Practice Address - Country:US
Practice Address - Phone:865-484-0881
Practice Address - Fax:865-484-0769
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000009540183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist