Provider Demographics
NPI:1922239342
Name:PIRTLE, BYRON MITCHELL (DPH)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:MITCHELL
Last Name:PIRTLE
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 1:1427 W BADDOUR PKWY STE B
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-3062
Mailing Address - Country:US
Mailing Address - Phone:615-449-3355
Mailing Address - Fax:615-449-0083
Practice Address - Street 1:1427 W BADDOUR PKWY STE B
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3062
Practice Address - Country:US
Practice Address - Phone:615-449-3355
Practice Address - Fax:615-449-0083
Is Sole Proprietor?:No
Enumeration Date:2009-08-03
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000004929183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist