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General NPI Number Information
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NPI Number | 1841568656
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Entity Type | Individual
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Provider Name | JOSEPH M ROBERTSON PHARM D
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Gender | Male
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 520 N MAGNOLIA ST
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City | LAUREL
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State | MS
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Zip | 39440-3559
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Country | US
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Telephone | 601-428-4334
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Fax | 601-428-1898
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Provider Business Mailing Address
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Address Line | 28 JORDAN RD
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City | ELLISVILLE
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State | MS
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Zip | 39437-8268
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Country | US
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Telephone | 601-498-7866
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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-09199
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License Number State | MS
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