Provider Demographics
NPI:1871946921
Name:HUBBARD, BRIAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1357 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:EUPORA
Mailing Address - State:MS
Mailing Address - Zip Code:39744-2064
Mailing Address - Country:US
Mailing Address - Phone:662-258-2631
Mailing Address - Fax:
Practice Address - Street 1:1357 VETERANS MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:EUPORA
Practice Address - State:MS
Practice Address - Zip Code:39744-2064
Practice Address - Country:US
Practice Address - Phone:662-258-2631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-14445183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist