Provider Demographics
NPI:1831488634
Name:RATLEY, JONATHAN S (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:S
Last Name:RATLEY
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 1:517 N GREEN ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-2947
Mailing Address - Country:US
Mailing Address - Phone:270-827-1897
Mailing Address - Fax:270-827-1809
Practice Address - Street 1:517 N GREEN ST
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:KY
Practice Address - Zip Code:42420-2947
Practice Address - Country:US
Practice Address - Phone:270-827-1897
Practice Address - Fax:270-827-1809
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013322183500000X
MD17936183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist