Individual
DR. SAMUEL TED BASIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM. D.
Contact information
Practice address
1776 MCCULLOUGH BLVD, TUPELO, MS 38801-7101
(662) 620-9606
Mailing address
1027 MEADOW BROOK RD, NEW ALBANY, MS 38652-8560
(662) 266-7761
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-010537
MS
Other
Enumeration date
08/29/2017
Last updated
08/29/2017
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