Individual
JOHNNIE L PATTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
815 S WHEATLEY ST, RIDGELAND, MS 39157-5002
(601) 957-1603
Mailing address
815 S WHEATLEY ST, RIDGELAND, MS 39157-5002
(601) 209-6513
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
R-4034
MS
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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