Provider Demographics
NPI:1821366279
Name:MORRIS, JONETHAN MICHAEL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JONETHAN
Middle Name:MICHAEL
Last Name:MORRIS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 S THOMAS ST STE B
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-5328
Mailing Address - Country:US
Mailing Address - Phone:662-260-3366
Mailing Address - Fax:662-269-1568
Practice Address - Street 1:146 S THOMAS ST STE B
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-5328
Practice Address - Country:US
Practice Address - Phone:662-260-3366
Practice Address - Fax:662-269-1568
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251F00000X, 261QI0500X
MSP11723183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No251F00000XAgenciesHome Infusion
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP11723OtherPHARMACIST LICENSE