Provider Demographics
NPI:1942229448
Name:LAXTON, DARLA TESS (PHARMD)
Entity Type:Individual
Prefix:
First Name:DARLA
Middle Name:TESS
Last Name:LAXTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TESS
Other - Middle Name:LAXTON
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 4129
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:TN
Mailing Address - Zip Code:37841-4129
Mailing Address - Country:US
Mailing Address - Phone:423-223-4303
Mailing Address - Fax:
Practice Address - Street 1:20029 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-3501
Practice Address - Country:US
Practice Address - Phone:423-569-8652
Practice Address - Fax:423-569-4080
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26962183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist