Healthcare Provider Details

I. General information

NPI: 1538479621
Provider Name (Legal Business Name): JONATHAN SCOTT BARTLETT PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1061 HARMON AVE
FORT STEWART GA
31314-5641
US

IV. Provider business mailing address

1061 HARMON AVE
FORT STEWART GA
31314-5641
US

V. Phone/Fax

Practice location:
  • Phone: 571-801-6572
  • Fax:
Mailing address:
  • Phone: 571-801-6572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00050912
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: