Provider Demographics
NPI:1730351396
Name:STONEKING, KENT BRADLY (PHARMD, CDE)
Entity type:Individual
Prefix:DR
First Name:KENT
Middle Name:BRADLY
Last Name:STONEKING
Suffix:
Gender:M
Credentials:PHARMD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 RIDGE LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9427
Mailing Address - Country:US
Mailing Address - Phone:901-765-4157
Mailing Address - Fax:901-765-4213
Practice Address - Street 1:800 RIDGE LAKE BLVD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-9427
Practice Address - Country:US
Practice Address - Phone:901-765-4157
Practice Address - Fax:901-765-4213
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8870183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist