Provider Demographics
NPI:1740655729
Name:STEWART, JONATHAN EUGENE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:EUGENE
Last Name:STEWART
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 1:1621 N BUSINESS 9
Mailing Address - Street 2:
Mailing Address - City:MORRILTON
Mailing Address - State:AR
Mailing Address - Zip Code:72110-4505
Mailing Address - Country:US
Mailing Address - Phone:501-354-4135
Mailing Address - Fax:501-354-4259
Practice Address - Street 1:1621 N BUSINESS 9
Practice Address - Street 2:
Practice Address - City:MORRILTON
Practice Address - State:AR
Practice Address - Zip Code:72110-4505
Practice Address - Country:US
Practice Address - Phone:501-354-4135
Practice Address - Fax:501-354-4259
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD08717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist