Provider Demographics
NPI:1922136688
Name:PATTON, LLOYD LEON JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:LLOYD
Middle Name:LEON
Last Name:PATTON
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:46 PATTON RD
Mailing Address - Street 2:
Mailing Address - City:HOLLANDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38748
Mailing Address - Country:US
Mailing Address - Phone:662-827-5339
Mailing Address - Fax:
Practice Address - Street 1:903 HIGHWAY 82 EAST
Practice Address - Street 2:BUILDING G
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751
Practice Address - Country:US
Practice Address - Phone:662-887-4135
Practice Address - Fax:662-887-9703
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE06213183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist