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Individual

DR. JONATHAN MARTIN MIDGORDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
11115 E US HIGHWAY 24, INDEPENDENCE, MO 64054-1567
(816) 833-2493
(816) 461-5817
Mailing address
1012 SW 14TH ST, LEES SUMMIT, MO 64081-3234
(816) 225-8421

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2014027817
MO

Other

Enumeration date
11/22/2020
Last updated
11/22/2020
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