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General NPI Number Information
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NPI Number | 1578713137
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Entity Type | Organization
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Legal Business Name | SETZER VISION LLC
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Dates
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Enumeration Date | 09/19/2008
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Last Update Date | 04/08/2016
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Provider Practice Location Address
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Address Line | 815 S WHEATLEY ST
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City | RIDGELAND
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State | MS
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Zip | 39157-5002
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Country | US
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Telephone | 601-991-1116
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Fax |
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Provider Business Mailing Address
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Address Line | 127 KATHERINE POINTE DR
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City | MADISON
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State | MS
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Zip | 39110-7909
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Country | US
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Telephone | 901-864-7075
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN JOSEPH SETZER JR.
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Credential | OD
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Telephone | 601-991-1116
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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 | 784
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License Number State | MS
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