Healthcare Provider Details

I. General information

NPI: 1891233060
Provider Name (Legal Business Name): JOHN TODD BARRETT R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2017
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TRACE COLONY PARK DR STE C
RIDGELAND MS
39157-8812
US

IV. Provider business mailing address

200 TRACE COLONY PARK DR STE C
RIDGELAND MS
39157-8812
US

V. Phone/Fax

Practice location:
  • Phone: 601-859-4342
  • Fax:
Mailing address:
  • Phone: 769-333-8805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7595
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number7754
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE7804
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: