Individual
SCOTT NULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2049 E SHILOH RD, CORINTH, MS 38834-3726
(662) 603-5521
Mailing address
2049 E SHILOH RD, CORINTH, MS 38834-3726
(662) 603-5521
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-101193
MS
Other
Enumeration date
07/17/2023
Last updated
07/17/2023
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