Organization
MEDICAL MALL VISION CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. W BOYCE CRAIG (OWNER)
(601) 957-5252
Entity
Organization
Contact information
Practice address
350 WEST WOODROW WILSON AVE, SUITE 3110, JACKSON, MS 39213-7681
(601) 366-9020
(601) 321-3979
Mailing address
350 W WOODROW WILSON AVE, SUITE 3110, JACKSON, MS 39213-7681
(601) 366-9020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04028327
—
MS
Enumeration date
10/25/2006
Last updated
08/22/2020
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