Individual
DR. JUSTIN NATHANIEL AUGUSTUS CHARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2996 CHURCH RD E, SOUTHAVEN, MS 38671-9825
(662) 349-4418
(662) 349-6689
Mailing address
2996 CHURCH RD E, SOUTHAVEN, MS 38671-9825
(662) 349-4418
(662) 349-6689
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
42731
TN
183500000X
Pharmacist
Primary
E-13581
MS
183500000X
Pharmacist
PST.021009
LA
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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