Provider Demographics
NPI:1427368737
Name:SMITH, JONATHAN ALLEN (PHARM D)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:ALLEN
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 FONTAINE DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-0715
Mailing Address - Country:US
Mailing Address - Phone:570-242-1442
Mailing Address - Fax:
Practice Address - Street 1:1009 WINDCROSS CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-2678
Practice Address - Country:US
Practice Address - Phone:443-492-5059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP444658183500000X
TN39198183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist