Individual
TOMMY RAY SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
680 HIGHWAY 51 STE G, RIDGELAND, MS 39157-2103
(601) 853-4611
Mailing address
680 HIGHWAY 51 STE G, RIDGELAND, MS 39157-2103
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E07064
MS
Other
Enumeration date
08/26/2019
Last updated
08/26/2019
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