Provider Demographics
NPI:1639820970
Name:SINCLAIR, JORDAN DAVID (PHARMD)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:DAVID
Last Name:SINCLAIR
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 1:115A N EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-1503
Mailing Address - Country:US
Mailing Address - Phone:314-454-6676
Mailing Address - Fax:314-367-1881
Practice Address - Street 1:115A N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1503
Practice Address - Country:US
Practice Address - Phone:314-454-6676
Practice Address - Fax:314-367-1881
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017037473183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist