Provider Demographics
NPI:1033586102
Name:GIFFORD, KEVIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:GIFFORD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 HILLSBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-0001
Mailing Address - Country:US
Mailing Address - Phone:919-286-1508
Mailing Address - Fax:919-286-1516
Practice Address - Street 1:2107 HILLSBOROUGH RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-0001
Practice Address - Country:US
Practice Address - Phone:919-286-1508
Practice Address - Fax:919-286-1516
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-25
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist