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General NPI Number Information
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NPI Number | 1851662100
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Entity Type | Individual
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Provider Name | JONATHAN EDWIN BARHAM PHARMD
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Gender | Male
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Dates
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Enumeration Date | 01/18/2012
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 136 HEALTH PARK DR
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City | MENA
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State | AR
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Zip | 71953-9072
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Country | US
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Telephone | 888-710-8220
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Fax |
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Provider Business Mailing Address
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Address Line | 711 S 22ND ST
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City | ARKADELPHIA
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State | AR
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Zip | 71923-5621
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Country | US
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Telephone | 931-743-8706
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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 | PD14325
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License Number State | AR
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