Provider Demographics
NPI:1124175138
Name:GARTEN, TIMOTHY SHAWN (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:SHAWN
Last Name:GARTEN
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 CURTISS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BARKSDALE AFB
Mailing Address - State:LA
Mailing Address - Zip Code:71110-2425
Mailing Address - Country:US
Mailing Address - Phone:318-456-6239
Mailing Address - Fax:318-456-6243
Practice Address - Street 1:243 CURTISS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BARKSDALE AFB
Practice Address - State:LA
Practice Address - Zip Code:71110-2425
Practice Address - Country:US
Practice Address - Phone:318-456-6239
Practice Address - Fax:318-456-6243
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV52261835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy