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General NPI Number Information
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NPI Number | 1902967847
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Entity Type | Organization
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Legal Business Name | BILL NOBLES & SON COUNTRY OPTICAL, INC.
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16 OFFICE PARK DR STE 3
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City | HATTIESBURG
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State | MS
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Zip | 39402-6021
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Country | US
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Telephone | 601-268-0671
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Fax | 601-264-4762
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Provider Business Mailing Address
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Address Line | 16 OFFICE PARK DR STE 3
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City | HATTIESBURG
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State | MS
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Zip | 39402-6021
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Country | US
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Telephone | 601-268-0671
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Fax | 601-264-4762
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Authorized Official
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Title or Position | CORP. SECRETARY
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Name | BETTY NOBLES
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Credential |
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Telephone | 601-268-0671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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