Provider Demographics
NPI:1770719270
Name:AKERS, JOHNATHAN SCOTT
Entity type:Individual
Prefix:MR
First Name:JOHNATHAN
Middle Name:SCOTT
Last Name:AKERS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USHINOYAMACHI 3 87 10
Mailing Address - Street 2:
Mailing Address - City:IWAKUNI
Mailing Address - State:YAMAGUCHI
Mailing Address - Zip Code:741 0071
Mailing Address - Country:JP
Mailing Address - Phone:0804-125-5702
Mailing Address - Fax:
Practice Address - Street 1:USHINOYAMACHI 3 87 10
Practice Address - Street 2:
Practice Address - City:IWAKUNI
Practice Address - State:YAMAGUCHI
Practice Address - Zip Code:741 0071
Practice Address - Country:JP
Practice Address - Phone:0804-125-5702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2009-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman