Provider Demographics
NPI:1003183781
Name:DAYTON, LEEANN GILMER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEEANN
Middle Name:GILMER
Last Name:DAYTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4910 POPLAR SPRINGS DR
Mailing Address - Street 2:WALGREENS - STORE 12537
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-1617
Mailing Address - Country:US
Mailing Address - Phone:601-483-3997
Mailing Address - Fax:601-483-9872
Practice Address - Street 1:4910 POPLAR SPRINGS DR
Practice Address - Street 2:WALGREENS - STORE 12537
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-1617
Practice Address - Country:US
Practice Address - Phone:601-483-3997
Practice Address - Fax:601-483-9872
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST-08202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist