Jimmy David Damron, D.PH.
Individual provider Active NPI Pharmacist · Fayetteville, TN
NPI 1811021074 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1811021074
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5423 (TN)
- Practice address
- 106 Elk Ave S
Fayetteville, TN 37334-3050 - Phone
- (931) 433-1511
- Fax
- (931) 433-6854
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5423 | TN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carters Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5423 | TN | Yes |
Addresses
Primary practice location
106 Elk Ave S
Fayetteville, TN 37334-3050
Mailing address
138 Taurus Dr
Harvest, AL 35749-9468
Phone (256) 852-1137
Other providers in Fayetteville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.