Provider Demographics
NPI:1780284836
Name:POSEY, JOHNATHAN ERIC (PD)
Entity type:Individual
Prefix:DR
First Name:JOHNATHAN
Middle Name:ERIC
Last Name:POSEY
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4717 OCEAN DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72405-5561
Mailing Address - Country:US
Mailing Address - Phone:479-774-5198
Mailing Address - Fax:
Practice Address - Street 1:2801 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:POCAHONTAS
Practice Address - State:AR
Practice Address - Zip Code:72455-9436
Practice Address - Country:US
Practice Address - Phone:870-892-6216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15382183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist