NPI 1033409669

Logan Kelley, PHARMD

Practitioner Pharmacist Vicksburg, MS

Practice location

Address: 2310 Clay St, Vicksburg, MS 39183-3123
Phone: (601) 661-5856
Mailing address: 107 Ashford Dr APT 2723, West Monroe, LA 71291-7916

Registered specialties (2)

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 010895 (MS)

Other Pharmacist providers in Mississippi →

Pharmacist

Pharmacy Service Providers Taxonomy 183500000X Licence 018795 (LA)

Registry record

NPI: 1033409669
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Apr 2011
Record last updated: 16 Apr 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.