Provider Demographics
NPI:1427679059
Name:PIERRE, KEVON JASON (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KEVON
Middle Name:JASON
Last Name:PIERRE
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 1:242 ARBOR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-5536
Mailing Address - Country:US
Mailing Address - Phone:305-600-8815
Mailing Address - Fax:
Practice Address - Street 1:242 ARBOR CREEK DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30157-5536
Practice Address - Country:US
Practice Address - Phone:305-600-8815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH028172183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty