Provider Demographics
NPI:1952589079
Name:JONES, STEPHEN RICHARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:RICHARD
Last Name:JONES
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 JUBILEE CIR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32124-2006
Mailing Address - Country:US
Mailing Address - Phone:386-274-7567
Mailing Address - Fax:
Practice Address - Street 1:123 JUBILEE CIR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32124-2006
Practice Address - Country:US
Practice Address - Phone:386-274-7567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-31
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0024573183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist