Provider Demographics
NPI:1891086039
Name:NIX, MARTHA MCCLURE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:MCCLURE
Last Name:NIX
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CLARKESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30523-5618
Mailing Address - Country:US
Mailing Address - Phone:706-754-4122
Mailing Address - Fax:706-754-9338
Practice Address - Street 1:1235 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CLARKESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30523-5618
Practice Address - Country:US
Practice Address - Phone:706-754-4122
Practice Address - Fax:706-754-9338
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023749183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist