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NPI Code Detail

MEDICARE: DR. DANISHICA PHALESSIA LAHOMA TROTTER PHARMD

MEDICARE: DR. DANISHICA PHALESSIA LAHOMA TROTTER PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistE-16209MS

General Provider Information

NPI Number : 1679177372
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DANISHICA PHALESSIA LAHOMA TROTTER PHARMD
Provider Business Mailing Address
First Line : 700 BEVERLY HILLS RD APT 712
Second Line :
City : HATTIESBURG
State : MS
Zip : 39401-4551
Country : US
Telephone Number : 601-433-2660
Fax Number :
Provider Business Practice Location Address
First Line : 1621 HIGHWAY 15 N
Second Line :
City : LAUREL
State : MS
Zip : 39440-2123
Country : US
Telephone Number : 601-649-4670
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2020
Last Update Date : 11/24/2020

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