Provider Demographics
NPI:1649483017
Name:BINKLEY, MARK F (DPH(PHARMACIST0)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:F
Last Name:BINKLEY
Suffix:
Gender:M
Credentials:DPH(PHARMACIST0
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 21ST AVE NORTH
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1856
Mailing Address - Country:US
Mailing Address - Phone:615-383-3784
Mailing Address - Fax:615-292-2762
Practice Address - Street 1:329 21ST AVE NORTH
Practice Address - Street 2:SUITE 3
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1856
Practice Address - Country:US
Practice Address - Phone:615-383-3784
Practice Address - Fax:615-292-2762
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000004307183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1649483017OtherINDIVIDUAL PROVIDER, NPI