Dr. Justin Lee Wilson, DPH
Pharmacist in Jacksboro, TN. Individual provider (NPI-1).
NPI number1285230714
StatusActive
Last updated in NPPESDec 9, 2020
Details
- NPI
- 1285230714
- Entity type
- Individual (NPI-1)
- Name
- Dr. Justin Lee Wilson
- Credential
- DPH
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 9, 2020
- Certification date
- Nov 16, 2020
- Last updated
- Dec 9, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 37476 | TN | Yes |
Practice location
2715 Jacksboro PikeJacksboro, TN 37757-4851
Phone 423-563-7455 · Fax 423-563-7448
Mailing address
2715 Jacksboro PikeJacksboro, TN 37757-4851
Phone 423-563-7455 · Fax 423-563-7448
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All 9 Pharmacist providers in Jacksboro · All 144 providers in Jacksboro
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