Provider Demographics
NPI:1982589164
Name:ONYIA, AUSTINE
Entity type:Individual
Prefix:DR
First Name:AUSTINE
Middle Name:
Last Name:ONYIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 BELLEVUE ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MS
Mailing Address - Zip Code:39056-3815
Mailing Address - Country:US
Mailing Address - Phone:601-519-9435
Mailing Address - Fax:
Practice Address - Street 1:204 CLINTON BLVD # MS 39056
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-5126
Practice Address - Country:US
Practice Address - Phone:601-926-1179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS101981183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist