Healthcare Provider Details

I. General information

NPI: 1295082923
Provider Name (Legal Business Name): ANN MCCLELLAN FRANKLIN DOCTOR OF PHARMACY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2012
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N DAVIS AVE
CLEVELAND MS
38732-2349
US

IV. Provider business mailing address

1418 TERRACE RD
CLEVELAND MS
38732-3036
US

V. Phone/Fax

Practice location:
  • Phone: 662-846-5781
  • Fax:
Mailing address:
  • Phone: 662-822-0135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE-12547
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: