Healthcare Provider Details

I. General information

NPI: 1134261282
Provider Name (Legal Business Name): ALLEN DIXON FINDLEY O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2711 GREENWAY DR SUITE A
JACKSON MS
39204-3304
US

IV. Provider business mailing address

2711 GREENWAY DR SUITE A
JACKSON MS
39204-3304
US

V. Phone/Fax

Practice location:
  • Phone: 601-922-9300
  • Fax: 601-922-6312
Mailing address:
  • Phone: 601-922-9300
  • Fax: 601-922-6312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number437
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: