Provider Demographics
NPI:1033716840
Name:PARIS, JONATHAN JOSEPH (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:JOSEPH
Last Name:PARIS
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LURAY DR STE B
Mailing Address - Street 2:
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953-3973
Mailing Address - Country:US
Mailing Address - Phone:740-314-5321
Mailing Address - Fax:740-314-8064
Practice Address - Street 1:200 LURAY DR STE B
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-3973
Practice Address - Country:US
Practice Address - Phone:740-314-5321
Practice Address - Fax:740-314-8064
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0008113183500000X
OH03233313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist