Provider Demographics
NPI:1568900215
Name:KUNTZ, JOHNATHAN JAMES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHNATHAN
Middle Name:JAMES
Last Name:KUNTZ
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 1:9418 E HIDDEN GREEN DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85262-2332
Mailing Address - Country:US
Mailing Address - Phone:414-852-4031
Mailing Address - Fax:
Practice Address - Street 1:5400 E. CAREFREE HIGHWAY
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331
Practice Address - Country:US
Practice Address - Phone:480-595-6755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS022328183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist