Organization
ANDERSON'S OPTIQUE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY JULIA ANDERSON (OFFICE MANAGER)
(601) 948-0582
Entity
Organization
Contact information
Practice address
4800 I 55 N, JACKSON, MS 39211-5555
(601) 948-0582
(601) 362-1392
Mailing address
4800 I 55 N, JACKSON, MS 39211-5555
(601) 948-0582
(601) 362-1392
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
UNLICENSED STATE
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00089008
—
MS
Enumeration date
01/15/2008
Last updated
01/15/2008
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