Provider Demographics
NPI:1477755312
Name:MCPHERSON, KEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:MCPHERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2263 BROOKSTONE CENTRE PKWY
Mailing Address - Street 2:STE C
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-4650
Mailing Address - Country:US
Mailing Address - Phone:706-341-4060
Mailing Address - Fax:706-341-4061
Practice Address - Street 1:2263 BROOKSTONE CENTRE PKWY
Practice Address - Street 2:STE C
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-4650
Practice Address - Country:US
Practice Address - Phone:706-341-4060
Practice Address - Fax:706-341-4061
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA651522084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry