Provider Demographics
NPI:1255867792
Name:DEYO, DEVON
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:DEYO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-9059
Mailing Address - Country:US
Mailing Address - Phone:740-852-7550
Mailing Address - Fax:740-852-7551
Practice Address - Street 1:230 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-9059
Practice Address - Country:US
Practice Address - Phone:740-852-7550
Practice Address - Fax:740-852-7551
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03225254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist