Provider Demographics
NPI:1033574611
Name:PARTIN, JAMIE DEWAYNE (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMIE
Middle Name:DEWAYNE
Last Name:PARTIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6780 S KY 11
Mailing Address - Street 2:
Mailing Address - City:BARBOURVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40906-7536
Mailing Address - Country:US
Mailing Address - Phone:606-622-0197
Mailing Address - Fax:606-337-3338
Practice Address - Street 1:114 N PINE ST
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:KY
Practice Address - Zip Code:40977-1647
Practice Address - Country:US
Practice Address - Phone:606-337-5050
Practice Address - Fax:606-337-0990
Is Sole Proprietor?:No
Enumeration Date:2015-12-23
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY011594183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist