Individual
MR. EDDIE O'BANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PD
Contact information
Practice address
2260 HIGHWAY 51 S, HERNANDO, MS 38632-1737
(662) 280-7457
(662) 280-7457
Mailing address
2260 HIGHWAY 51 S, HERNANDO, MS 38632-1737
(662) 280-7457
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
T-08835
MS
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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