Healthcare Provider Details

I. General information

NPI: 1477852572
Provider Name (Legal Business Name): WILLIAM WEBB FORBES RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2011
Last Update Date: 03/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6075 OLD CANTON RD
JACKSON MS
39211-3335
US

IV. Provider business mailing address

6075 OLD CANTON RD
JACKSON MS
39211-3335
US

V. Phone/Fax

Practice location:
  • Phone: 601-957-3900
  • Fax: 601-957-2956
Mailing address:
  • Phone: 601-957-3900
  • Fax: 601-957-2956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE6602
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: