Individual
DR. WILBURN LORD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
239 S WASHINGTON AVE, GREENVILLE, MS 38701-4234
(662) 332-0163
(662) 378-3394
Mailing address
239 S WASHINGTON AVE, GREENVILLE, MS 38701-4234
(662) 332-0163
(662) 378-3394
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
460
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087850
—
MS
Enumeration date
02/09/2007
Last updated
07/08/2007
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