Individual
BAILEY MELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
15917 BOUNDARY DRIVE, ASHLAND, MS 38603
(662) 224-8922
Mailing address
15917 BOUNDARY DRIVE, ASHLAND, MS 38603
(662) 224-8922
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
010796
MS
183500000X
Pharmacist
35515
TN
183500000X
Pharmacist
PD11450
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010796
PHARMACY LICENSE, MISSISSIPPI
MS
Enumeration date
01/04/2011
Last updated
01/04/2011
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