Provider Demographics
NPI:1124628102
Name:LINDSEY, BETSY WICKER (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:WICKER
Last Name:LINDSEY
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 SMITHDALE RD
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39648-2064
Mailing Address - Country:US
Mailing Address - Phone:601-684-1445
Mailing Address - Fax:601-684-3616
Practice Address - Street 1:1608 SMITHDALE RD
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-2064
Practice Address - Country:US
Practice Address - Phone:601-684-1445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09148183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist