Provider Demographics
NPI:1992072367
Name:DABBS, LARRY WAYNE (DPH)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:WAYNE
Last Name:DABBS
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 1:805 NASHVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-2430
Mailing Address - Country:US
Mailing Address - Phone:931-380-3065
Mailing Address - Fax:931-381-9330
Practice Address - Street 1:805 NASHVILLE HWY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-2430
Practice Address - Country:US
Practice Address - Phone:931-380-3065
Practice Address - Fax:931-381-9330
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist