Provider Demographics
NPI:1396015616
Name:DAVIS, JASON M (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:M
Last Name:DAVIS
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 1:834 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44303-1034
Mailing Address - Country:US
Mailing Address - Phone:330-434-4997
Mailing Address - Fax:330-434-1973
Practice Address - Street 1:834 W MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44303-1034
Practice Address - Country:US
Practice Address - Phone:330-434-4997
Practice Address - Fax:330-434-1973
Is Sole Proprietor?:No
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03127469183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist