Provider Demographics
NPI:1023002276
Name:KIMBREL, JASON M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:M
Last Name:KIMBREL
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 1:9058 EVERSOLE RUN RD
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8424
Mailing Address - Country:US
Mailing Address - Phone:614-306-0157
Mailing Address - Fax:
Practice Address - Street 1:250 PROGRESSIVE WAY
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9615
Practice Address - Country:US
Practice Address - Phone:614-306-0157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2019-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-261561835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy