Healthcare Provider Details

I. General information

NPI: 1275645889
Provider Name (Legal Business Name): SANDRA LYNN BRIGHT O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 HIGHWAY 51 N
BATESVILLE MS
38606-2347
US

IV. Provider business mailing address

102 HIGHWAY 51 N
BATESVILLE MS
38606-2347
US

V. Phone/Fax

Practice location:
  • Phone: 662-210-6004
  • Fax: 662-563-9882
Mailing address:
  • Phone: 662-210-6004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156FC0801X
TaxonomyContact Lens Fitter
License Number736
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code156FX1100X
TaxonomyOphthalmic Technician/Technologist
License Number736
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number736
License Number StateMS
# 4
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number736P-Y
License Number StateMS
# 5
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number736
License Number StateMS
# 6
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number736
License Number StateMS
# 7
Primary TaxonomyN
Taxonomy Code156FC0800X
TaxonomyContact Lens Technician/Technologist
License Number736
License Number StateMS
# 8
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number736
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: