Provider Demographics
NPI:1861641110
Name:SIFFRARD, ADERSON (PHARMD)
Entity Type:Individual
Prefix:
First Name:ADERSON
Middle Name:
Last Name:SIFFRARD
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 1:1130 STONEBRIDGE PARK DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-4020
Mailing Address - Country:US
Mailing Address - Phone:901-484-6886
Mailing Address - Fax:
Practice Address - Street 1:1130 STONEBRIDGE PARK DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-4020
Practice Address - Country:US
Practice Address - Phone:901-484-6886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist