Provider Demographics
NPI:1881845311
Name:MYERS, DANNY R (RPH)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:R
Last Name:MYERS
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 1:5315 OLD HIGHWAY 11
Mailing Address - Street 2:SUITE #4
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-6224
Mailing Address - Country:US
Mailing Address - Phone:601-271-2006
Mailing Address - Fax:601-271-2452
Practice Address - Street 1:5315 OLD HIGHWAY 11
Practice Address - Street 2:SUITE #4
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-6224
Practice Address - Country:US
Practice Address - Phone:601-271-2006
Practice Address - Fax:601-271-2452
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-06260183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist