Provider Demographics
NPI:1760601157
Name:STURGEON, EDDIE (DPH)
Entity Type:Individual
Prefix:DR
First Name:EDDIE
Middle Name:
Last Name:STURGEON
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 DAVY CROCKETT SHOPPING CENTER
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:TN
Mailing Address - Zip Code:38382-3202
Mailing Address - Country:US
Mailing Address - Phone:731-855-1000
Mailing Address - Fax:731-855-2400
Practice Address - Street 1:114 DAVY CROCKETT SHOPPING CENTER
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382-3202
Practice Address - Country:US
Practice Address - Phone:731-855-1000
Practice Address - Fax:731-855-2400
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4361183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist