Provider Demographics
NPI:1871621250
Name:COMBS, MARSHALL CLAY (DPH)
Entity type:Individual
Prefix:
First Name:MARSHALL
Middle Name:CLAY
Last Name:COMBS
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 CHRISTIAN CHURCH RD APT 41
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-4584
Mailing Address - Country:US
Mailing Address - Phone:865-696-5567
Mailing Address - Fax:
Practice Address - Street 1:1735 W STATE OF FRANKLIN RD
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6573
Practice Address - Country:US
Practice Address - Phone:423-929-2611
Practice Address - Fax:423-929-8301
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC-5636183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist