Individual
DR. CODY AUSTIN TAWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2320 5TH ST N, COLUMBUS, MS 39705-2214
(662) 328-4300
Mailing address
2320 5TH ST N, COLUMBUS, MS 39705-2214
(662) 328-4300
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-14390
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E-14390
MISSISSIPPI BOARD OF PHARMACY
MS
Enumeration date
01/04/2019
Last updated
01/04/2019
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