Individual
DR. TINA RENEE SOREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1501 LAKELAND DR, SUITE 100, JACKSON, MS 39216-4834
(601) 366-1085
(601) 366-5186
Mailing address
1501 LAKELAND DR, SUITE 100, JACKSON, MS 39216-4834
(601) 366-1085
(601) 366-5186
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
637
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015291
—
MS
Enumeration date
11/25/2005
Last updated
11/28/2012
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