Provider Demographics
NPI:1285414060
Name:KNUTSON, TROY JAMES (PHARMD)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:JAMES
Last Name:KNUTSON
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 1:3109 WALNUT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-3509
Mailing Address - Country:US
Mailing Address - Phone:901-515-3430
Mailing Address - Fax:901-515-3439
Practice Address - Street 1:3109 WALNUT GROVE RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-3509
Practice Address - Country:US
Practice Address - Phone:901-515-3430
Practice Address - Fax:901-515-3439
Is Sole Proprietor?:No
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7265183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist