Individual
MR. BILLY CLAY CLANTON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
6745 S SIWELL RD, BYRAM, MS 39272-8747
(601) 863-2004
(601) 863-2016
Mailing address
214 SUMMER HILL ROAD, MADISON, MS 39110
(601) 607-7137
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
E-09006
MS
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
E-09006
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E09006
PHARMACY LICENSE
MS
Enumeration date
05/02/2007
Last updated
01/13/2020
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