Individual
MR. JAMES L. JELKS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R. PH.
Contact information
Practice address
149 MAIN ST., CENTREVILLE, MS 39631-0159
(601) 645-5411
(601) 645-6454
Mailing address
PO BOX 159, CENTREVILLE, MS 39631-0159
(601) 645-5411
(601) 645-6454
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
E-06942
MS
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
3336C0003X
Community/Retail Pharmacy
01649
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030372
—
MS
05
—
00440293
—
MS
Enumeration date
03/02/2007
Last updated
09/11/2025
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