Individual
MR. STEPHEN LAVERN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5796 US HIGHWAY 11, PURVIS, MS 39475-5004
(601) 794-5525
(601) 794-2741
Mailing address
PO BOX 407, PURVIS, MS 39475-0407
(601) 794-5525
(601) 794-2741
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
T08078
MS
Other
Enumeration date
06/07/2021
Last updated
06/07/2021
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