Individual
MR. WILLIAM KELLY BOUTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
428 HIGHWAY 51 N, BROOKHAVEN, MS 39601-2351
(601) 833-7455
(601) 833-3987
Mailing address
428 HIGHWAY 51 N, BROOKHAVEN, MS 39601-2351
(601) 833-7455
(601) 833-3987
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E08687
MS
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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