Provider Demographics
NPI:1407850001
Name:EVERLY, JASON JAMES (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:JAMES
Last Name:EVERLY
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8020 VEGAS CIR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-9290
Mailing Address - Country:US
Mailing Address - Phone:513-860-0407
Mailing Address - Fax:
Practice Address - Street 1:1300 PARKWOOD CIRCLE SE
Practice Address - Street 2:SUITE 325 ECG, LLC,,
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339
Practice Address - Country:US
Practice Address - Phone:513-846-7283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH0218091835P1200X
OH033255551835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy