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General NPI Number Information
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NPI Number | 1306446471
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Entity Type | Individual
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Provider Name | LANCE NEWLON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 1608 VETERANS BLVD
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City | MCCOMB
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State | MS
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Zip | 39648-2064
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Country | US
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Telephone | 601-684-1445
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Fax |
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Provider Business Mailing Address
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Address Line | 1045 TURKEY RIDGE RD
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City | SUMMIT
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State | MS
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Zip | 39666-9134
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Country | US
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Telephone | 601-248-2620
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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 | 10724
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License Number State | MS
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