Provider Demographics
NPI:1114066511
Name:ROBB, JON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:
Last Name:ROBB
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 1:1506 HAWTHORNE CT
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:IN
Mailing Address - Zip Code:47670-3334
Mailing Address - Country:US
Mailing Address - Phone:812-385-2638
Mailing Address - Fax:
Practice Address - Street 1:4924 S MAPLE TREE DRIVE
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:IN
Practice Address - Zip Code:47670
Practice Address - Country:US
Practice Address - Phone:812-387-4000
Practice Address - Fax:812-387-4001
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26019411A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist