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General NPI Number Information
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NPI Number | 1144586546
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Entity Type | Organization
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Legal Business Name | REFLECTIONS VISION CENTER
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Dates
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Enumeration Date | 04/10/2012
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Last Update Date | 04/10/2012
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Provider Practice Location Address
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Address Line | 101-C LEXINGTON DR.
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City | MADISON
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State | MS
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Zip | 39110
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Country | US
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Telephone | 601-255-5052
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Fax |
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Provider Business Mailing Address
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Address Line | 101-C LEXINGTON DR.
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City | MADISON
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State | MS
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Zip | 39110
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. MARJORIE LENOIR
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Credential | O.D.
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Telephone | 601-255-5052
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 788
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License Number State | MS
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