Provider Demographics
NPI:1376852723
Name:DAVIS, GUINN TERRY (RPH)
Entity Type:Individual
Prefix:MR
First Name:GUINN
Middle Name:TERRY
Last Name:DAVIS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:229 N UNION ST
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MS
Mailing Address - Zip Code:39046-3728
Mailing Address - Country:US
Mailing Address - Phone:601-859-4681
Mailing Address - Fax:601-859-0635
Practice Address - Street 1:229 N UNION ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MS
Practice Address - Zip Code:39046-3728
Practice Address - Country:US
Practice Address - Phone:601-859-4681
Practice Address - Fax:601-859-0635
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-6306183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist