Most Relevant Information
Provider Data
| NPI Number: | 1003416223 |
| Provider Name: | DEIDRE REYNOLDS PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | E-09848 |
Most Important Dates
| Enumeration Date: | 10/27/2020 |
| Last Updated: | 10/27/2020 |
Provider Practice Location
6072 U S HIGHWAY 98
HATTIESBURG
MS
394028854
Practice Location Phone/Fax
| Phone: | 6012643631 |
| Fax: | 6012640526 |
Provider Mailing Location
6072 U S HIGHWAY 98
HATTIESBURG
MS
394028854
Provider Mailing Phone/Fax
| Phone: | 6012643631 |
| Fax: | 6012640526 |