Provider Demographics
NPI:1124299359
Name:LINDLEY, BRENT JOHNSTON (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:JOHNSTON
Last Name:LINDLEY
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 HARDY ST
Mailing Address - Street 2:PHARMACY
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1308
Mailing Address - Country:US
Mailing Address - Phone:601-296-3486
Mailing Address - Fax:601-268-8482
Practice Address - Street 1:5001 HARDY ST
Practice Address - Street 2:PHARMACY
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1308
Practice Address - Country:US
Practice Address - Phone:601-296-3486
Practice Address - Fax:601-268-8482
Is Sole Proprietor?:No
Enumeration Date:2008-03-15
Last Update Date:2008-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-095641835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy