Organization
MAURICE JAMES OPHTHALMOLOGY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE IVY (INSURANCE MANAGER)
(601) 362-4467
Entity
Organization
Contact information
Practice address
971 LAKELAND DR, SUITE 563, JACKSON, MS 39216-4643
(601) 362-4467
(601) 362-0239
Mailing address
971 LAKELAND DR, SUITE 563, JACKSON, MS 39216-4643
(601) 362-4467
(601) 362-0239
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
8996
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0010144
—
MS
01
—
428989680A
BLUE CROSS BLUE SHIELD PIN
MS
Enumeration date
10/23/2014
Last updated
10/23/2014
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