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MR. BARRY DAYTON CRIDDLE R.PH.

>> Pharmacist >> Pharmacy Service Providers

Registrant NPI Number: 1659898328

Individual Registrant:
MR. BARRY DAYTON CRIDDLE R.PH.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
101 W SWEET POTATO ST  VARDAMAN, MS 38878-9433 US
Tel: 662-682-7489  Fax: --

Contact information for business:
2504 PHILP DR  TUPELO, MS 38801-6109 US
Tel: 662-549-5232  Fax: --

Registration Information:
NPI: 1659898328
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y183500000XPharmacy Service Providers
Pharmacist
MSE-07893

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
MS BOARD OF PHARMACY LICENSEE-07893MS01
MS DRIVERS LICENSE800278784MS01




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