Provider Demographics
NPI:1518027382
Name:DAVID, ROCKY W (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROCKY
Middle Name:W
Last Name:DAVID
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:PO BOX 201
Mailing Address - Street 2:
Mailing Address - City:PIGEON FORGE
Mailing Address - State:TN
Mailing Address - Zip Code:37868-0201
Mailing Address - Country:US
Mailing Address - Phone:865-436-3729
Mailing Address - Fax:
Practice Address - Street 1:3346 PARKWAY
Practice Address - Street 2:
Practice Address - City:PIGEON FORGE
Practice Address - State:TN
Practice Address - Zip Code:37863-3423
Practice Address - Country:US
Practice Address - Phone:865-453-5470
Practice Address - Fax:865-428-3677
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist