# LINDSTROM EYE & LASER CENTER, P.A.

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

## Provider details

- **NPI number:** 1780724583
- **Authorized official:** DR. JUDITH BRADLEY M.D. (M.D.)
- **Authorized official phone:** (601) 428-0999

## Contact information

- **Practice address:** 1020 ADAMS ST, LAUREL, MS 39440-4365
- **Practice address phone:** (601) 426-9454
- **Practice address fax:** (601) 426-9476
- **Mailing address:** PO BOX 407, LAUREL, MS 39441-0407
- **Mailing address phone:** (601) 426-9454
- **Mailing address fax:** (601) 426-9476

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/08/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 09013550 | — | MS |