Provider Demographics
NPI:1821380684
Name:WHITSON, EVERETT DILLARD (RPH PHARMD)
Entity Type:Individual
Prefix:
First Name:EVERETT
Middle Name:DILLARD
Last Name:WHITSON
Suffix:
Gender:M
Credentials:RPH PHARMD
Other - Prefix:
Other - First Name:EVERETT
Other - Middle Name:DILLARD
Other - Last Name:WHITSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:932 OLD GAINESBORO HWY
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-8939
Mailing Address - Country:US
Mailing Address - Phone:931-267-0993
Mailing Address - Fax:931-243-4691
Practice Address - Street 1:1000 GAINESBORO HWY
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TN
Practice Address - Zip Code:38551
Practice Address - Country:US
Practice Address - Phone:931-243-2673
Practice Address - Fax:931-243-4691
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000007427183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist