Provider Demographics
NPI:1801887328
Name:EIDSON, KEVIN KENT (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:KENT
Last Name:EIDSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:232 MARLIN RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HOUSE
Mailing Address - State:TN
Mailing Address - Zip Code:37188-8951
Mailing Address - Country:US
Mailing Address - Phone:615-253-2311
Mailing Address - Fax:615-532-2785
Practice Address - Street 1:425 5TH AVE N
Practice Address - Street 2:5TH FLOOR, CORDELL HULL BUILDING
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37247-0001
Practice Address - Country:US
Practice Address - Phone:615-253-2311
Practice Address - Fax:615-532-2785
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist