Provider Demographics
NPI:1245613512
Name:HUNTSMAN, CHAD BARCLAY (PHARMD)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:BARCLAY
Last Name:HUNTSMAN
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 1:2106 E AJ HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-5412
Mailing Address - Country:US
Mailing Address - Phone:423-586-0721
Mailing Address - Fax:423-587-5419
Practice Address - Street 1:2106 E AJ HWY
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-5412
Practice Address - Country:US
Practice Address - Phone:423-586-0721
Practice Address - Fax:423-587-5419
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-06
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39133183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist