Healthcare Provider Details

I. General information

NPI: 1336439082
Provider Name (Legal Business Name): KEVIN LLOYD CLEMENT PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2011
Last Update Date: 10/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1453 HOPE WAY
MURFREESBORO TN
37129-3140
US

IV. Provider business mailing address

1453 HOPE WAY
MURFREESBORO TN
37129-3140
US

V. Phone/Fax

Practice location:
  • Phone: 615-893-9390
  • Fax: 615-893-4162
Mailing address:
  • Phone: 615-893-9390
  • Fax: 615-893-4162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7726
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: