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General NPI Number Information
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NPI Number | 1952905135
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Entity Type | Individual
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Provider Name | MITCHELL BRENT MYERS
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Gender | Male
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Dates
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Enumeration Date | 11/28/2020
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Last Update Date | 11/28/2020
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Provider Practice Location Address
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Address Line | 1014 HIGHWAY 51
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City | MADISON
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State | MS
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Zip | 39110-8304
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Country | US
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Telephone | 601-856-2021
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Fax |
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Provider Business Mailing Address
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Address Line | 1014 HIGHWAY 51
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City | MADISON
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State | MS
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Zip | 39110-8304
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Country | US
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Telephone | 601-856-2021
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Fax | 601-856-2061
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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 | 19264
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PHA.0021188
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS54560
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PST.021374
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License Number State | LA
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Taxonomy #5
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 39898
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License Number State | TN
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Taxonomy #6
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 50026
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License Number State | TX
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Taxonomy #7
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | T-14186
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License Number State | MS
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