Provider Demographics
NPI:1457755738
Name:VO, JASON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:VO
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 1:3644 WILLGROVE WAY
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8715
Mailing Address - Country:US
Mailing Address - Phone:940-395-4905
Mailing Address - Fax:
Practice Address - Street 1:35 COLLIER RD NW STE 100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1780
Practice Address - Country:US
Practice Address - Phone:404-350-9772
Practice Address - Fax:404-355-8966
Is Sole Proprietor?:No
Enumeration Date:2014-10-15
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH027605183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist