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General NPI Number Information
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NPI Number | 1407850001
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Entity Type | Individual
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Provider Name | JASON JAMES EVERLY PHARM.D., R.PH.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 1300 PARKWOOD CIRCLE SE SUITE 325 ECG, LLC,,
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City | ATLANTA
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State | GA
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Zip | 30339
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Country | US
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Telephone | 513-846-7283
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Fax |
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Provider Business Mailing Address
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Address Line | 8020 VEGAS CIR
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City | WEST CHESTER
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State | OH
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Zip | 45069-9290
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Country | US
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Telephone | 513-860-0407
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | RPH021809
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 03325555
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License Number State | OH
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