Basic Information
Provider Information
NPI: 1841304177
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KINDLE
FirstName: JOEL
MiddleName: TODD
NamePrefix: DR.
NameSuffix:  
Credential: BS PHARM D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 374 GOODMAN CEMETERY RD
Address2:  
City: PINEY FLATS
State: TN
PostalCode: 37686
CountryCode: US
TelephoneNumber: 4235383094
FaxNumber:  
Practice Location
Address1: CORNER OF SYDNEY AND LAMONT STREETS
Address2: MOUNTAIN HOME VAMC
City: MOUNTAIN HOME
State: TN
PostalCode: 376847000
CountryCode: US
TelephoneNumber: 4239261171
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/17/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X8801TNY Pharmacy Service ProvidersPharmacist 

No ID Information.


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