Provider Demographics
NPI:1508456757
Name:CALDWELL, KEVIN NEAL (PHARMD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:NEAL
Last Name:CALDWELL
Suffix:
Gender:M
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:PO BOX 498
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:AR
Mailing Address - Zip Code:72560-0498
Mailing Address - Country:US
Mailing Address - Phone:870-269-4329
Mailing Address - Fax:
Practice Address - Street 1:100 CASE COMMONS DR
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:AR
Practice Address - Zip Code:72560-5016
Practice Address - Country:US
Practice Address - Phone:870-269-4329
Practice Address - Fax:870-269-4722
Is Sole Proprietor?:No
Enumeration Date:2021-01-21
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD09130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist