Organization
ADVANCED VISION CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN BENTON LYON MD (PHYSICIAN/OWNER)
(601) 649-2450
Entity
Organization
Contact information
Practice address
705 SAWMILL RD, LAUREL, MS 39440-3937
(601) 649-2450
(601) 649-0556
Mailing address
PO BOX 1965, LAUREL, MS 39441-1965
(601) 649-2450
(601) 649-0556
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200001782
—
MS
Enumeration date
11/29/2007
Last updated
04/03/2024
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