Individual
MITCHELL BRENT MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1014 HIGHWAY 51, MADISON, MS 39110-8304
(601) 856-2021
Mailing address
1014 HIGHWAY 51, MADISON, MS 39110-8304
(601) 856-2021
(601) 856-2061
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
19264
AL
183500000X
Pharmacist
39898
TN
183500000X
Pharmacist
50026
TX
183500000X
Pharmacist
PHA.0021188
CO
183500000X
Pharmacist
PS54560
FL
183500000X
Pharmacist
PST.021374
LA
183500000X
Pharmacist
Primary
T-14186
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00888740
—
MS
Enumeration date
11/28/2020
Last updated
11/28/2020
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