Individual
DR. JACOB STANDEFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4062 HIXSON PIKE, CHATTANOOGA, TN 37415-3110
(423) 877-3568
Mailing address
4062 HIXSON PIKE, CHATTANOOGA, TN 37415-3110
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000043642
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
0
—
Enumeration date
04/10/2020
Last updated
11/27/2023
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