Provider Demographics
NPI:1275616831
Name:HUDSON, EWELL SPENCER (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:EWELL
Middle Name:SPENCER
Last Name:HUDSON
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 COURT SQ
Mailing Address - Street 2:P. O. BOX 526
Mailing Address - City:SUMNER
Mailing Address - State:MS
Mailing Address - Zip Code:38957
Mailing Address - Country:US
Mailing Address - Phone:662-375-8813
Mailing Address - Fax:662-375-8883
Practice Address - Street 1:108 N COURT
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:MS
Practice Address - Zip Code:38957-0526
Practice Address - Country:US
Practice Address - Phone:662-375-8813
Practice Address - Fax:662-375-8883
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-52541835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy