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Individual

DR. JERRY MCBRIDE LLC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
301 HOSPITAL RD, FULTON, MS 38843-0519
(662) 862-9741
(662) 862-3584
Mailing address
PO BOX 519, 301 HOSPITAL RD, FULTON, MS 38843-0519
(662) 862-9741
(662) 862-3584

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
425
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00087670
MS
Enumeration date
01/11/2007
Last updated
03/18/2013
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