Organization
ENVISION EYE CARE, INC
Active
Parent organization
ENVISION EYE CARE, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ENVISION EYE CARE, INC
Authorized official
DR. TONYATTA T HAIRSTON O.D. (OWNER/OPTOMETRIST)
(601) 987-3937
Entity
Organization
Contact information
Practice address
1100 JR LYNCH ST, SUITE 5, JACKSON, MS 39203-3311
(601) 487-6812
(601) 487-6818
Mailing address
1100 JR LYNCH ST, SUITE 5, JACKSON, MS 39203-3311
(601) 487-6812
(601) 487-6818
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
658
MS
261QH0100X
Health Service Clinic/Center
825
MS
261QH0100X
Health Service Clinic/Center
844
MS
Other
Enumeration date
09/21/2011
Last updated
09/21/2011
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