Provider Demographics
NPI:1689602203
Name:ENGLISH, TRACY S (RPH)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:S
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 PAUL FRANKLIN RD
Mailing Address - Street 2:
Mailing Address - City:CLARKESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30523-6606
Mailing Address - Country:US
Mailing Address - Phone:706-754-5570
Mailing Address - Fax:706-754-5570
Practice Address - Street 1:199 E LOUISE ST
Practice Address - Street 2:
Practice Address - City:CLARKESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30523-6019
Practice Address - Country:US
Practice Address - Phone:706-754-3933
Practice Address - Fax:706-754-3974
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA017306183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist