Provider Demographics
NPI:1902438435
Name:GARY, JAMES THOMAS (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THOMAS
Last Name:GARY
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 1:1524 OSAGE CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-0705
Mailing Address - Country:US
Mailing Address - Phone:615-425-6144
Mailing Address - Fax:
Practice Address - Street 1:2100 LOWES DR
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6688
Practice Address - Country:US
Practice Address - Phone:931-906-3181
Practice Address - Fax:931-906-8143
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-12
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0210301835P0018X
TN00000435761835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist