Provider Demographics
NPI:1386635407
Name:MARQUESS, JONATHAN GRIFFIN (PHARMD, CDE)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:GRIFFIN
Last Name:MARQUESS
Suffix:
Gender:M
Credentials:PHARMD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2451 TYNE TER SE
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-5986
Mailing Address - Country:US
Mailing Address - Phone:678-923-4263
Mailing Address - Fax:770-973-3032
Practice Address - Street 1:8612 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-4829
Practice Address - Country:US
Practice Address - Phone:770-926-6478
Practice Address - Fax:770-571-7557
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0176231835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy