Provider Demographics
NPI:1639521644
Name:YOUNG, TIMOTHY BLAKE (PHARMD, MBA)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:BLAKE
Last Name:YOUNG
Suffix:
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-5100
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 MOUNTAIN CREEK RD STE 440
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-6101
Practice Address - Country:US
Practice Address - Phone:423-206-9840
Practice Address - Fax:423-206-9841
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26111183500000X
TN40166183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist