Individual
DR. FRED JOEL STANDEFER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPH
Contact information
Practice address
3051 MAIN STREET, PIKEVILLE, TN 37367-0150
(423) 447-2134
(423) 447-6330
Mailing address
PO BOX 150, PIKEVILLE, TN 37367-0150
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
TN4735
TN
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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