Individual
DR. LAURIE WADE CAGLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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, FULTON, MS 38843-0519
(662) 862-9741
(662) 862-3584
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
740
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00834230
—
MS
Enumeration date
01/10/2007
Last updated
12/19/2008
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