Provider Demographics
NPI:1023229580
Name:CUTRER, GEORGE (PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:CUTRER
Suffix:
Gender:M
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3341 HALLS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39180-5338
Mailing Address - Country:US
Mailing Address - Phone:601-661-9340
Mailing Address - Fax:601-661-9358
Practice Address - Street 1:132 FAIRMONT ST
Practice Address - Street 2:SUITE C
Practice Address - City:CLINTON
Practice Address - State:MS
Practice Address - Zip Code:39056-4721
Practice Address - Country:US
Practice Address - Phone:601-925-5822
Practice Address - Fax:601-925-5812
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-7075183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist