Individual
DEBORAH SOUTHERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
110 N 11TH ST, MIDDLESBORO, KY 40965-1024
(606) 242-2013
Mailing address
110 N 11TH ST, MIDDLESBORO, KY 40965-1024
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0000046320
TN
183500000X
Pharmacist
Primary
022775
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0
—
KY
Enumeration date
07/26/2022
Last updated
07/26/2022
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