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General NPI Number Information
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NPI Number | 1518111574
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Entity Type | Individual
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Provider Name | JILL FRIER O.D.
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Gender | Female
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Dates
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Enumeration Date | 11/04/2008
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Last Update Date | 08/09/2014
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Provider Practice Location Address
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Address Line | 2152 IOWA BLVD
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City | VICKSBURG
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State | MS
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Zip | 39180-5572
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Country | US
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Telephone | 601-636-3937
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Fax | 601-638-0944
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Provider Business Mailing Address
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Address Line | PO BOX 4066
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City | BRANDON
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State | MS
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Zip | 39047-4066
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Country | US
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Telephone | 601-636-3937
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Fax | 601-638-0944
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | S-B95-TA-806
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License Number State | AL
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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 | 804
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 603
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License Number State | NM
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