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General NPI Number Information
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NPI Number | 1649042532
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Entity Type | Individual
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Provider Name | JONATHAN LOTT PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/24/2023
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 1311 S WALTON BLVD
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City | BENTONVILLE
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State | AR
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Zip | 72712-6284
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Country | US
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Telephone | 479-268-7979
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Fax |
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Provider Business Mailing Address
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Address Line | 1840 SUNRISE CIR
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City | CENTERTON
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State | AR
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Zip | 72719-5040
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Country | US
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Telephone | 479-387-6273
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PD16718
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License Number State | AR
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