Provider Demographics
NPI:1336743053
Name:DUCKWORTH, CHRISTOPHER LOWELL (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:LOWELL
Last Name:DUCKWORTH
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 1:674 COUNTY ROAD 442
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:TN
Mailing Address - Zip Code:37303-6479
Mailing Address - Country:US
Mailing Address - Phone:423-368-3074
Mailing Address - Fax:
Practice Address - Street 1:2424 N OCOEE ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-3854
Practice Address - Country:US
Practice Address - Phone:423-473-7874
Practice Address - Fax:423-473-7211
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000027817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist