# MAURICE JAMES OPHTHALMOLOGY, PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649675364
- **Authorized official:** MICHELE IVY (INSURANCE MANAGER)
- **Authorized official phone:** (601) 362-4467

## Contact information

- **Practice address:** 971 LAKELAND DR, SUITE 563, JACKSON, MS 39216-4643
- **Practice address phone:** (601) 362-4467
- **Practice address fax:** (601) 362-0239
- **Mailing address:** 971 LAKELAND DR, SUITE 563, JACKSON, MS 39216-4643
- **Mailing address phone:** (601) 362-4467
- **Mailing address fax:** (601) 362-0239

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 8996 | MS | Yes |

## Other

- **Enumeration date:** 10/23/2014
- **Last updated:** 10/23/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0010144 | — | MS |
| 01 | — | 428989680A | BLUE CROSS BLUE SHIELD PIN | MS |