Provider Demographics
NPI:1306980628
Name:O'BAR, JAIME SUZANNE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:SUZANNE
Last Name:O'BAR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JAIME
Other - Middle Name:SUZANNE
Other - Last Name:ANDREWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:9741 TAYLOR DR
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-6596
Mailing Address - Country:US
Mailing Address - Phone:662-893-3717
Mailing Address - Fax:888-343-7337
Practice Address - Street 1:4284 GETWELL RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38118-6801
Practice Address - Country:US
Practice Address - Phone:901-238-2742
Practice Address - Fax:888-343-7337
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12108183500000X
NE12144183500000X
ARPD10409183500000X
MSE09557183500000X
LA17629183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist