Provider Demographics
NPI:1881676252
Name:JEFFRIES, JOSEPH ALAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:ALAN
Last Name:JEFFRIES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69755 CRESTVIEW LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-8313
Mailing Address - Country:US
Mailing Address - Phone:740-695-5972
Mailing Address - Fax:
Practice Address - Street 1:639 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BARNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43713-1039
Practice Address - Country:US
Practice Address - Phone:740-425-5108
Practice Address - Fax:740-425-5131
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03217976183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist