Individual
JOHNATHAN TYLER DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
2425 S ZERO ST, FORT SMITH, AR 72901-8663
(479) 646-6382
Mailing address
1 RED OAK LN, RUSSELLVILLE, AR 72802-9068
(870) 880-0777
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD13950
AR
Other
Enumeration date
04/07/2022
Last updated
05/20/2025
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