Provider Demographics
NPI:1760584072
Name:KING, JAMES BRIAN (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BRIAN
Last Name:KING
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 1:205 QUAIL POINT DR
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37166-4944
Mailing Address - Country:US
Mailing Address - Phone:615-887-3170
Mailing Address - Fax:931-815-8070
Practice Address - Street 1:460 W BOCKMAN WAY
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-1833
Practice Address - Country:US
Practice Address - Phone:931-836-1500
Practice Address - Fax:931-836-8070
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000083521835P1200X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy