Provider Demographics
NPI:1972666881
Name:HERRON, JEFFERY ROHN (RPH)
Entity type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:ROHN
Last Name:HERRON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:811 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:YANKTON
Mailing Address - State:SD
Mailing Address - Zip Code:57078-3622
Mailing Address - Country:US
Mailing Address - Phone:605-668-3182
Mailing Address - Fax:605-668-3156
Practice Address - Street 1:3515 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:YANKTON
Practice Address - State:SD
Practice Address - Zip Code:57078-4917
Practice Address - Country:US
Practice Address - Phone:605-668-3182
Practice Address - Fax:605-668-3156
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD42181835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric