Provider Demographics
NPI:1821491663
Name:CARLISLE, TIMOTHY ROSS (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ROSS
Last Name:CARLISLE
Suffix:
Gender:M
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3573 HILLSBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2916
Mailing Address - Country:US
Mailing Address - Phone:919-383-0171
Mailing Address - Fax:
Practice Address - Street 1:3573 HILLSBOROUGH RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2916
Practice Address - Country:US
Practice Address - Phone:919-383-0171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24293183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist