Provider Demographics
NPI:1104324854
Name:COMPTON, MICHAEL GLENN (PHARMD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GLENN
Last Name:COMPTON
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 1:2315 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5454
Mailing Address - Country:US
Mailing Address - Phone:931-552-3535
Mailing Address - Fax:931-552-3235
Practice Address - Street 1:2315 MADISON ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5454
Practice Address - Country:US
Practice Address - Phone:931-552-3535
Practice Address - Fax:931-552-3235
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN329751835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist