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General NPI Number Information
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NPI Number | 1548157068
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Entity Type | Individual
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Provider Name | JUSTIN VO OD
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Gender | Male
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 08/10/2025
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Provider Practice Location Address
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Address Line | 1801 FULLER RD BLDG 367
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City | MERIDIAN
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State | MS
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Zip | 39309-5106
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Country | US
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Telephone | 601-679-2210
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Fax |
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Provider Business Mailing Address
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Address Line | 4501 HIGHWAY 39 N APT 3A
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City | MERIDIAN
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State | MS
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Zip | 39301-1003
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Country | US
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Telephone | 918-633-9127
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Fax |
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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 | 0618003523
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License Number State | VA
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