Individual
MR. JAMES ALBERT BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH, CDE
Contact information
Practice address
2049 SHILOH RD, CORINTH, MS 38834
(662) 415-1684
Mailing address
13 TYSON TRL, IUKA, MS 38852-6433
(662) 415-1684
(662) 286-5533
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
E5169
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E5169
LICENSE
MS
Enumeration date
05/01/2007
Last updated
03/26/2013
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