Provider Demographics
NPI:1194093732
Name:NOBLE, JOHN C (RPH)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:NOBLE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6308 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39211-2033
Mailing Address - Country:US
Mailing Address - Phone:601-952-2979
Mailing Address - Fax:601-952-0192
Practice Address - Street 1:6308 RIDGEWOOD RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39211-2033
Practice Address - Country:US
Practice Address - Phone:601-952-2979
Practice Address - Fax:601-952-0192
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-10
Last Update Date:2011-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSD7234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist