Provider Demographics
NPI:1063013084
Name:PATTON, ELIZABETH ANNETTE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNETTE
Last Name:PATTON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 RICKY D BRITT SR BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-9110
Mailing Address - Country:US
Mailing Address - Phone:166-261-4158
Mailing Address - Fax:
Practice Address - Street 1:1655 SUNSET DR
Practice Address - Street 2:
Practice Address - City:GRENADA
Practice Address - State:MS
Practice Address - Zip Code:38901-4061
Practice Address - Country:US
Practice Address - Phone:662-226-6550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-05
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-15587183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist