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Individual
DR. JASON SOUTHWORTH
Active
Individual
DR. JASON SOUTHWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13903
NC
3336C0003X
Community/Retail Pharmacy
14673
NC
Other
Enumeration date
10/30/2009
Last updated
06/14/2024
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