Provider Demographics
NPI:1780901215
Name:WHITWELL, WILLIAM R JR (PHARMD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:WHITWELL
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371A HIGHLAND COLONY PKWY
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-6035
Mailing Address - Country:US
Mailing Address - Phone:601-326-5760
Mailing Address - Fax:
Practice Address - Street 1:371A HIGHLAND COLONY PKWY
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-6035
Practice Address - Country:US
Practice Address - Phone:601-326-5760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-23
Last Update Date:2017-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS12391183500000X
AL16390183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist