Individual
RANDALL LAVELLE CAMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
915 HILL ST, ELLISVILLE, MS 39437-2419
(601) 477-3573
(601) 477-3572
Mailing address
110 TIMBERTON DR, HATTIESBURG, MS 39401-9043
(601) 408-5568
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
R-06559
MS
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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