Provider Demographics
NPI:1629574918
Name:OSBON, BILLY CLIFTON JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:BILLY
Middle Name:CLIFTON
Last Name:OSBON
Suffix:JR
Gender:M
Credentials:RPH
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Mailing Address - Street 1:2506 LAKELAND DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232
Mailing Address - Country:US
Mailing Address - Phone:866-420-4041
Mailing Address - Fax:601-420-4040
Practice Address - Street 1:2506 LAKELAND DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232
Practice Address - Country:US
Practice Address - Phone:866-420-4041
Practice Address - Fax:601-420-4040
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MSP08628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist