Provider Demographics
NPI:1780360727
Name:SILVERS, JACOB NATHANIEL (PHARMD)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:NATHANIEL
Last Name:SILVERS
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 1:8026 E MAGGIE CT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-4550
Mailing Address - Country:US
Mailing Address - Phone:520-338-4677
Mailing Address - Fax:
Practice Address - Street 1:4151 E HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2425
Practice Address - Country:US
Practice Address - Phone:520-452-7929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS026302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist