Provider Demographics
NPI:1922792613
Name:SKELTON, RONALD EARL (RPH)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:EARL
Last Name:SKELTON
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 1:850 HIGHWAY 469 S
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MS
Mailing Address - Zip Code:39073-9066
Mailing Address - Country:US
Mailing Address - Phone:601-954-9003
Mailing Address - Fax:
Practice Address - Street 1:1201 HIGHWAY 49 S
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:MS
Practice Address - Zip Code:39218-9425
Practice Address - Country:US
Practice Address - Phone:601-932-8609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-6613183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist