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General NPI Number Information
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NPI Number | 1730721564
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Entity Type | Individual
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Provider Name | BRITNEY DODSON BLACKWELL
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Gender | Female
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Dates
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Enumeration Date | 10/14/2019
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Last Update Date | 10/14/2019
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Provider Practice Location Address
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Address Line | 830 S GLOSTER ST
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City | TUPELO
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State | MS
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Zip | 38801-4996
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Country | US
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Telephone | 662-377-4583
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Fax |
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Provider Business Mailing Address
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Address Line | 366 COUNTY ROAD 373
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City | TUPELO
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State | MS
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Zip | 38801-9051
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Country | US
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Telephone | 662-645-9808
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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-12536
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License Number State | MS
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