Provider Demographics
NPI:1184903072
Name:STURGEON, EDWARD CLINTON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:CLINTON
Last Name:STURGEON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 DAVY CROCKETT MALL
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:TN
Mailing Address - Zip Code:38382-2934
Mailing Address - Country:US
Mailing Address - Phone:731-487-0431
Mailing Address - Fax:
Practice Address - Street 1:114 DAVY CROCKETT MALL
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382-2934
Practice Address - Country:US
Practice Address - Phone:731-487-0431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35836183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist