Provider Demographics
NPI:1942918065
Name:OZEGOVICH, KIRA (PHARMD)
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:
Last Name:OZEGOVICH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 ASHBROOKE WAY APT 714
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-6395
Mailing Address - Country:US
Mailing Address - Phone:843-813-9727
Mailing Address - Fax:
Practice Address - Street 1:5320 CLINTON HWY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-3844
Practice Address - Country:US
Practice Address - Phone:865-688-5711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist