Provider Demographics
NPI:1447672837
Name:ALLRED, JONATHAN DOUGLAS (PHARM D)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:DOUGLAS
Last Name:ALLRED
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 844
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-0844
Mailing Address - Country:US
Mailing Address - Phone:931-397-5504
Mailing Address - Fax:931-879-9365
Practice Address - Street 1:346 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-3407
Practice Address - Country:US
Practice Address - Phone:931-879-8133
Practice Address - Fax:931-879-9365
Is Sole Proprietor?:No
Enumeration Date:2014-01-20
Last Update Date:2014-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000033715183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist