Provider Demographics
NPI:1497789598
Name:BAGGETT, RONALD JAY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JAY
Last Name:BAGGETT
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 1:133 E RACE ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:TN
Mailing Address - Zip Code:37763-2824
Mailing Address - Country:US
Mailing Address - Phone:865-376-6452
Mailing Address - Fax:865-376-7729
Practice Address - Street 1:133 E RACE ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:TN
Practice Address - Zip Code:37763-2824
Practice Address - Country:US
Practice Address - Phone:865-376-6452
Practice Address - Fax:865-376-7729
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6519183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist