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General NPI Number Information
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NPI Number | 1265033682
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Entity Type | Individual
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Provider Name | TARA TUTOR JAMES
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Gender | Female
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Dates
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Enumeration Date | 11/03/2020
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Last Update Date | 11/03/2020
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Provider Practice Location Address
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Address Line | 100 MCCORD RD
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City | PONTOTOC
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State | MS
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Zip | 38863-6245
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Country | US
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Telephone | 662-489-5421
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Fax | 662-489-7424
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Provider Business Mailing Address
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Address Line | 410 COTTON ACRES
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City | PONTOTOC
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State | MS
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Zip | 38863-8559
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Country | US
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Telephone | 662-509-0000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | E-11928
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License Number State | MS
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