Provider Demographics
NPI:1598365173
Name:SCALES, LANDON D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LANDON
Middle Name:D
Last Name:SCALES
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8869 OAK GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-9359
Mailing Address - Country:US
Mailing Address - Phone:901-438-7119
Mailing Address - Fax:
Practice Address - Street 1:950 MACKIE DR
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:38635-7406
Practice Address - Country:US
Practice Address - Phone:662-252-9988
Practice Address - Fax:662-252-7762
Is Sole Proprietor?:No
Enumeration Date:2020-10-31
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE15720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist