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General NPI Number Information
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NPI Number | 1174635700
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Entity Type | Organization
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Legal Business Name | BATESVILLE VISION CLINIC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 365 HIGHWAY 51 N
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City | BATESVILLE
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State | MS
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Zip | 38606-2311
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Country | US
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Telephone | 662-563-9880
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Fax | 662-563-9882
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Provider Business Mailing Address
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Address Line | 365 HIGHWAY 51 N
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City | BATESVILLE
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State | MS
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Zip | 38606-2311
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Country | US
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Telephone | 662-563-9880
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Fax | 662-563-9882
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Authorized Official
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Title or Position | OWNER/ DOCTOR
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Name | DR. GLEN H. STONE
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Credential | O.D.
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Telephone | 662-563-9880
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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 | 535
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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 | 736
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License Number State | MS
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