Provider Demographics
NPI:1417553231
Name:DOWD-DAVIS, KIMBERLY EVON (PHARMD)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:EVON
Last Name:DOWD-DAVIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 SUNCREST DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39212-2529
Mailing Address - Country:US
Mailing Address - Phone:601-373-2111
Mailing Address - Fax:601-372-7846
Practice Address - Street 1:2803 SUNCREST DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39212-2529
Practice Address - Country:US
Practice Address - Phone:601-373-2111
Practice Address - Fax:601-372-7846
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09351183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist