Provider Demographics
NPI:1841350196
Name:KIRKPATRICK, EDWARD FREEMAN JR (DDS)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:FREEMAN
Last Name:KIRKPATRICK
Suffix:JR
Gender:M
Credentials:DDS
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 410
Mailing Address - Street 2:307 REED ST
Mailing Address - City:PORTLAND
Mailing Address - State:TN
Mailing Address - Zip Code:37148-0410
Mailing Address - Country:US
Mailing Address - Phone:615-325-4466
Mailing Address - Fax:
Practice Address - Street 1:307 REED ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:TN
Practice Address - Zip Code:37148-0410
Practice Address - Country:US
Practice Address - Phone:615-325-4466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000001691122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist