DR. TYLER DOUGHERTY (NPI# 1023487055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023487055 |
| Entity Type | Individual |
| Full Name | DR. TYLER DOUGHERTY |
| Credential | PHARMD |
| Practice Address |
1130 N Charles G Seivers Blvd Clinton TN 37716-3937 |
| Practice Telephone | 8654571421 |
| Mailing Telephone | 8654571421 |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2017-12-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 39420 | TN | Pharmacy Service Providers |
| Street Address |
1130 N CHARLES G SEIVERS BLVD |
| City | CLINTON |
| State | TN |
| Zip Code | 37716-3937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730650870 | Kellye Watkins Wilson | Dental Hygienist | 420 S. Charles Seivers Blvd, Clinton, TN 37716 | 2018-12-16 |
| 1326428087 | Sandra Ella Humphrey Mincey | Registered Nurse | Mcneeley Family Physicians, 110 Executive Park Drive, Clinton, TN 37716 | 2015-06-08 |
| 1598157224 | Susan Price Teffeteller | Nurse Practitioner | 159 Frank L Diggs Road, Clinton, TN 37716 | 2015-03-04 |
| 1710268065 | Jimmy Neil Mcbride | Pharmacist | 1130 North Charles G. Seivers Boulevard, Clinton Drug Store, Clinton, TN 37716 | 2011-08-31 |
| 1265684658 | K-va-t Food Stores, Inc. | Durable Medical Equipment & Medical Supplies | 507 South Charles Sevier Boulevard, Clinton, TN 37716 | 2008-10-16 |
| 1912186016 | Comprehensive Industrial Services Inc | Physical Therapist | 1107 Charles Seivers Blvd, Suite 2, Clinton, TN 37716 | 2007-10-25 |
| 1205039120 | Pamela H. Gross, Ph.d, P.C. | Psychologist | 1729 Dutch Valley Road, Clinton, TN 37716 | 2007-06-07 |
| 1396872057 | Health Care Inc | Pharmacy | 1130 N Charles Seivers Blvd, Clinton, TN 37716 | 2007-02-28 |
| 1346389889 | Kellie Gaetz | Physical Therapist | 1115 Charles Seivers Blvd, Suite 22, Clinton, TN 37716 | 2007-02-05 |
| 1396883955 | Phoenix Counseling Services, Inc. | Counselor | 729 Charles Seivers, Clinton, TN 37716 | 2007-02-02 |
| Find all providers in zip 37716 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841582 | Autumn Brooke Trifone | Pharmacist | 1795 In 163, Clinton, IN 47842 | 2020-11-04 |
| 1447857909 | Marinda Renee Bryan | Pharmacist | 2526 Hwy 65 S. Ste 101, Clinton, AR 72031 | 2020-10-07 |
| 1811455629 | Deva Sandroni | Pharmacist | 132 Fairmont St Ste B, Clinton, MS 39056-4721 | 2019-03-11 |
| 1225514458 | April Walker | Pharmacist | 100 N. 30th, Clinton, OK 73601 | 2018-07-11 |
| 1659857845 | Sally Drinnon | Pharmacist | 200 S 30th St, Clinton, OK 73601-3657 | 2018-07-11 |
| 1730673237 | Raisa Vladimir Reznik | Pharmacist | 6300 Coventry Way, Clinton, MD 20735-2256 | 2018-06-18 |
| 1962929331 | Jonathan Glen Hubanks | Pharmacist | 202 Clinton Blvd, Clinton, MS 39056-5126 | 2017-08-27 |
| 1871022830 | Mary Venetta Rothermal | Pharmacist | 140 W Michigan Ave, Clinton, MI 49236-9577 | 2017-06-05 |
| 1689028896 | Bridget Piko | Pharmacist | 165 Clinton Lake Rd, Clinton, PA 15026-1927 | 2016-04-14 |
| 1386038222 | Erica Podar | Pharmacist | 507 S Charles G Seivers Blvd, Clinton, TN 37716-2723 | 2015-03-27 |
| Find all providers in CLINTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.