MEDICARE: STEPHEN LYLE DEAN

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
1	183500000X	Pharmacist	E-08138	MS

General Provider Information

NPI Number	:	1740124106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN LYLE DEAN

Provider Business Mailing Address
First Line	:	4 WILLOW PT STE 70
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-1150
Country	:	US
Telephone Number	:	601-550-6773
Fax Number	:	601-620-2882

Provider Business Practice Location Address
First Line	:	4 WILLOW PT STE 70
Second Line	:
City	:	HATTIESBURG
State	:	MS
Zip	:	39402-1150
Country	:	US
Telephone Number	:	601-550-6773
Fax Number	:	601-620-2882

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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Directions to “ STEPHEN LYLE DEAN ” Practice Location

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