Organization
RONALD MOZINGO, OD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINGER KEEN (MANAGER)
(601) 261-2467
Entity
Organization
Contact information
Practice address
6096 U S HIGHWAY 98, SUITE 1-A, HATTIESBURG, MS 39402-8885
(601) 261-2467
(601) 296-6685
Mailing address
6096 U S HIGHWAY 98, SUITE 1-A, HATTIESBURG, MS 39402-8885
(601) 261-2467
(601) 296-6685
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
470
MS
152W00000X
Optometrist
826
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087886
—
MS
05
—
04289596
—
MS
Enumeration date
06/01/2012
Last updated
06/01/2012
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