Healthcare Provider Details

I. General information

NPI: 1871653287
Provider Name (Legal Business Name): J&R OPTICAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 01/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 LOWER WOODVILLE ROAD #19
NATCHEZ MS
39120-4451
US

IV. Provider business mailing address

PO BOX 18482
NATCHEZ MS
39122-8482
US

V. Phone/Fax

Practice location:
  • Phone: 601-597-2366
  • Fax: 601-445-2282
Mailing address:
  • Phone: 601-597-2366
  • Fax: 601-445-2282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. REBECCA O FRANCIS
Title or Position: PRESIDENT
Credential: OPTICIAN
Phone: 601-597-2366