Clarence Lee Middleton, RPH

Primary specialty

PharmacyTaxonomy code 333600000X

License

T-13037 Issued in MS

Practice address

122 S Front St
Ellisville, MS 39437-3118

Phone

(601) 477-8587

NPI assigned

Jun 4, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Nikki R Walters

  • Community/Retail Pharmacy
  • Ellisville, MS
  • NPI 1316046402
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1496534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496534400000",
    "number": "1043749070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S COURT ST",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394373112",
            "telephone_number": "864-710-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S FRONT ST",
            "city": "ELLISVILLE",
            "state": "MS",
            "postal_code": "394373118",
            "telephone_number": "601-477-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "CLARENCE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-04",
        "last_updated": "2017-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "T-13037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine N McCardle
• Kathleen Frances McCoy, P.T.
• Audrey McCullum, CCSS
• Tina Denise McDyess, PHD
• Lacey Leigh McLaurin, M.S. R.D.
• Tony Earl Miller, N.P.
• Tracie Miller, CCSS
• Mississippi State Department of Health
• Alecia A Moore, DMD
• Joseph Rodney Moring, M.D.

• All providers in Ellisville, MS
• Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.