Healthcare Provider Details

I. General information

NPI: 1629673926
Provider Name (Legal Business Name): MEG WILLIAMS R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 E JACKSON ST
BELZONI MS
39038-3642
US

IV. Provider business mailing address

124 E JACKSON ST
BELZONI MS
39038-3642
US

V. Phone/Fax

Practice location:
  • Phone: 662-247-3530
  • Fax:
Mailing address:
  • Phone: 662-247-3530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberD-07456
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberD-7456
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: