Individual
MR. KENNETH LEO SANDIFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2 MEDICAL BLVD, HATTIESBURG, MS 39401-7230
(601) 268-5740
(601) 268-5858
Mailing address
2 MEDICAL BLVD, HATTIESBURG, MS 39401-7230
(601) 268-5740
(601) 268-5858
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E06324
MS
Other
Enumeration date
10/26/2007
Last updated
10/26/2007
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