Provider Demographics
NPI:1083829097
Name:TURNER, JUDY DOOLITTLE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:DOOLITTLE
Last Name:TURNER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:958 HIGHWAY 9 N
Mailing Address - Street 2:
Mailing Address - City:BANNER
Mailing Address - State:MS
Mailing Address - Zip Code:38913-5019
Mailing Address - Country:US
Mailing Address - Phone:662-414-7124
Mailing Address - Fax:
Practice Address - Street 1:958 HIGHWAY 9 N
Practice Address - Street 2:
Practice Address - City:BANNER
Practice Address - State:MS
Practice Address - Zip Code:38913-5019
Practice Address - Country:US
Practice Address - Phone:662-414-7124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE08128183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSE08128OtherPHARMACIST LICENSE