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General NPI Number Information
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NPI Number | 1184671489
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Entity Type | Organization
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Legal Business Name | JACKSON EYE ASSOCIATES PLLC
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 04/01/2013
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Provider Practice Location Address
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Address Line | 102 CLINTON PKWY THIRD FLOOR
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City | CLINTON
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State | MS
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Zip | 39056-4730
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Country | US
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Telephone | 601-924-9750
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Fax | 601-925-9125
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Provider Business Mailing Address
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Address Line | 1190 N STATE ST SUITE 403
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City | JACKSON
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State | MS
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Zip | 39202-2413
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Country | US
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Telephone | 601-353-2020
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Fax | 601-714-5110
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. JOHN H MCVEY
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Credential | M.D.
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Telephone | 601-353-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 20061221
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License Number State | MS
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