Jason A Bonner, PHARM.D.
Individual provider Active NPI Pharmacist · Clayton, GA
NPI 1316239122 · NPPES record last updated Aug 5, 2014
Key facts
- NPI
- 1316239122
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- RPH027870 (GA)
- Practice address
- 1455 U.S. 441
Clayton, GA 30525 - Phone
- (706) 782-3730
- NPI assigned
- May 11, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH027870 | GA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH027870 | GA | Yes |
Addresses
Primary practice location
1455 U.S. 441
Clayton, GA 30525
Mailing address
1455 U.S. 441
Clayton, GA 30525
Phone (706) 782-3730
Other providers in Clayton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.