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NPI Code Detail

MEDICARE: JONATHAN M. WALTON-ROBERTS PHARM.D.

MEDICARE:   JONATHAN M. WALTON-ROBERTS  PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH023033GA

General Provider Information

NPI Number : 1538760822
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN M. WALTON-ROBERTS PHARM.D.
Provider Business Mailing Address
First Line : 4221 ATLANTA HWY
Second Line :
City : LOGANVILLE
State : GA
Zip : 30052-7316
Country : US
Telephone Number : 770-554-6785
Fax Number : 770-554-4985
Provider Business Practice Location Address
First Line : 4221 ATLANTA HWY
Second Line :
City : LOGANVILLE
State : GA
Zip : 30052-7316
Country : US
Telephone Number : 770-554-6785
Fax Number : 770-554-4985
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/04/2020
Last Update Date : 11/04/2020

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Directions to “ JONATHAN M. WALTON-ROBERTS PHARM.D.” Practice Location

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