Anderson's Optique, Inc.

Primary specialty

OcularistTaxonomy code 156FX1700X

License

UNLICENSED STATE Issued in MS

Legal business name

ANDERSON'S OPTIQUE, INC.

Practice address

4800 I 55 N
Jackson, MS 39211-5555

Phone

(601) 948-0582

Fax

(601) 362-1392

NPI assigned

Jan 15, 2008

Last updated

Jan 15, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Mary Julia Anderson

Title

Office Manager

Phone

(601) 948-0582

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200355200000",
    "number": "1497931877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 I 55 N",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115555",
            "telephone_number": "601-948-0582",
            "fax_number": "601-362-1392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 I 55 N",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392115555",
            "telephone_number": "601-948-0582",
            "fax_number": "601-362-1392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON'S OPTIQUE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-15",
        "last_updated": "2008-01-15",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JULIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "601-948-0582",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": "MS",
            "license": "UNLICENSED STATE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00089008",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen David Anderson, M.D.
• Stephen Davis Anderson, MD
• Tanericha Lashay Anderson
• Tionna Alexis Tina Anderson
• Trevan D Anderson, DO
• Anamaria Andrei, M.D
• Rebekah Andrew Ayyasamy
• Andrew K. Dulaney, DMD
• Bentia Andrews, LCSW
• Darlenia T Andrews, NP

• Technician/Technologist in Jackson, MS
• Providers in Jackson, MS by specialty
• Technician/Technologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.