Individual
CEIL D DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
977 ELLIS AVE, JACKSON, MS 39209-6256
(601) 944-9965
Mailing address
977 ELLIS AVE, JACKSON, MS 39209-6256
(601) 944-9965
(601) 709-7875
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
07873
MS
183500000X
Pharmacist
1320432
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1320432
—
MS
Enumeration date
01/01/2012
Last updated
01/01/2012
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