Provider Demographics
NPI:1912041153
Name:CARDEN, LARRY G (DPH)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:G
Last Name:CARDEN
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 1:478 BEST ST
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063-2056
Mailing Address - Country:US
Mailing Address - Phone:731-635-2905
Mailing Address - Fax:731-635-5798
Practice Address - Street 1:288 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-1737
Practice Address - Country:US
Practice Address - Phone:731-635-1461
Practice Address - Fax:731-635-5798
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000003249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist