Individual
MR. STANLEY RAY MIXON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
8549 HIGHWAY 17, WINNSBORO, LA 71295-5425
(318) 435-5139
Mailing address
8549 HIGHWAY 17, WINNSBORO, LA 71295-5425
(318) 435-5139
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
019726
GA
183500000X
Pharmacist
Primary
042208
AR
183500000X
Pharmacist
10409
LA
183500000X
Pharmacist
13610
AL
183500000X
Pharmacist
E-05812
MS
Other
Enumeration date
09/17/2010
Last updated
09/17/2010
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