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General NPI Number Information
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NPI Number | 1114448800
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Entity Type | Organization
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Legal Business Name | MEGAN SUMRALL, OD, PLLC
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 7127 HIGHWAY 98 SUITE 30
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City | HATTIESBURG
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State | MS
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Zip | 39402
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Country | US
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Telephone | 601-470-2020
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Fax | 800-493-5956
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Provider Business Mailing Address
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Address Line | 7117 US HWY 98 SUITE 30
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City | HATTIESBURG
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State | MS
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Zip | 39402
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Country | US
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Telephone | 601-475-2020
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Fax | 800-493-5956
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Authorized Official
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Title or Position | MANAGER
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Name | MEGAN LOTT
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Credential | OD
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Telephone | 601-475-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 760
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 760
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License Number State | MS
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