Tupelo Eye Center Optical Shop

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

041067620 Issued in MS

Legal business name

TUPELO EYE CENTER OPTICAL SHOP

Practice address

610 Brunson Dr
Tupelo, MS 38801-4947

Phone

(662) 844-7211

Fax

(662) 680-4455

NPI assigned

Apr 14, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Ryan D Russell, O.D.

Title

Optometrist

Phone

(662) 844-7211

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1801215272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 BRUNSON DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014947",
            "telephone_number": "662-844-7211",
            "fax_number": "662-680-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 BRUNSON DR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014947",
            "telephone_number": "662-844-7211",
            "fax_number": "662-680-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUPELO EYE CENTER OPTICAL SHOP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "662-844-7211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "MS",
            "license": "041067620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Eyewear Supplier in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.