Healthcare Provider Details

I. General information

NPI: 1598975740
Provider Name (Legal Business Name): BARBARA G. WELLS PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 COUNTY ROAD 102
OXFORD MS
38655-9617
US

IV. Provider business mailing address

156 COUNTY ROAD 102
OXFORD MS
38655-9617
US

V. Phone/Fax

Practice location:
  • Phone: 662-234-6465
  • Fax: 662-915-5118
Mailing address:
  • Phone: 662-234-6465
  • Fax: 662-915-5118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberC3224
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: