Mangum, Stacy Allen

Mangum, Stacy Allen is an individual health care provider with primary practice located at 1200 N One Mile Rd Missouri Southern Healthcare, Dexter MO 63841-1000. He recently has only one registered license in Pharmacy Service Providers / Pharmacotherapy, which is considered as his primary health care specialty. Mangum, Stacy Allen can be contacted via phone (573) 614-1957.

Contact Information

Primary practice address
1200 N One Mile Rd Missouri Southern Healthcare Dexter MO 63841-1000
Fax: (573) 624-6265
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacotherapy 1835P1200X 044733 Missouri

Profile Details

NPI number 1619968237
LBN Legal business name Mangum, Stacy Allen
Credentials PHARM.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2005
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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