Individual
BRENT A SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2159 S LAMAR BLVD, OXFORD, MS 38655-5223
(662) 236-2222
Mailing address
BSUTHERLAND49@GMAIL.COM, OXFORD, MS 38655
(601) 214-5561
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-13686
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E-13686
MS BOARD OF PHARMACY LICENSE NUMBER
MS
Enumeration date
01/21/2021
Last updated
01/21/2021
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