Individual
DR. FALLON MUMFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
633 HIGHWAY 82 W, INDIANOLA, MS 38751-2078
(662) 887-3788
Mailing address
310 SYCAMORE ST, LELAND, MS 38756-3314
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-010293
MS
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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