Provider Demographics
NPI:1588976765
Name:DOSS, GRETCHEN LEIGH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:LEIGH
Last Name:DOSS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664-3385
Mailing Address - Country:US
Mailing Address - Phone:423-246-0234
Mailing Address - Fax:
Practice Address - Street 1:2200 MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37664-3385
Practice Address - Country:US
Practice Address - Phone:423-246-0234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-05
Last Update Date:2010-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000033846183500000X
VA0202207925183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist