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NPI Code Detail

MEDICARE: DR. KYLE RICHARD COPELAND PHARM.D., BCPS

MEDICARE: DR. KYLE RICHARD COPELAND PHARM.D., BCPS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist11693TN
21835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist11693TN
31835P1200XPharmacotherapy Pharmacist3140290FTN

General Provider Information

NPI Number : 1124098801
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KYLE RICHARD COPELAND PHARM.D., BCPS
Provider Business Mailing Address
First Line : 9352 PARK WEST BLVD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4325
Country : US
Telephone Number : 865-373-1042
Fax Number : 865-373-1041
Provider Business Practice Location Address
First Line : 9352 PARK WEST BLVD
Second Line :
City : KNOXVILLE
State : TN
Zip : 37923-4325
Country : US
Telephone Number : 865-373-1042
Fax Number : 865-373-1041
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2006
Last Update Date : 02/10/2015

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