Individual
MR. TERRY WADE STUBBLEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
1065 COUNTY ROAD 228, ECRU, MS 38841
(662) 587-3284
Mailing address
1065 COUNTY ROAD 228, ECRU, MS 38841
(662) 587-3284
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E7002
MS
Other
Enumeration date
02/09/2012
Last updated
11/27/2012
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