Provider Demographics
NPI:1255614384
Name:COWART, SPENCER PRESLEY (PHARM D)
Entity type:Individual
Prefix:MR
First Name:SPENCER
Middle Name:PRESLEY
Last Name:COWART
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5320 CLINTON HWY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-3844
Mailing Address - Country:US
Mailing Address - Phone:865-688-5711
Mailing Address - Fax:865-688-8781
Practice Address - Street 1:5320 CLINTON HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-3844
Practice Address - Country:US
Practice Address - Phone:865-688-5711
Practice Address - Fax:865-688-8781
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28103183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist