Provider Demographics
NPI:1942728555
Name:CAMERON, TARA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TARA
Middle Name:
Last Name:CAMERON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CLINTON PLAZA
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056
Mailing Address - Country:US
Mailing Address - Phone:601-924-3232
Mailing Address - Fax:601-924-2417
Practice Address - Street 1:200 CLINTON PLAZA
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056
Practice Address - Country:US
Practice Address - Phone:601-924-3232
Practice Address - Fax:601-924-2417
Is Sole Proprietor?:No
Enumeration Date:2017-09-03
Last Update Date:2017-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09391183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist