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General NPI Number Information
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NPI Number | 1942584693
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Entity Type | Organization
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Legal Business Name | FRIER FAMILY EYE CARE INC
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Dates
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Enumeration Date | 09/29/2011
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Last Update Date | 12/03/2019
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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 | 601-778-0107
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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 |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JILL FRIER
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Credential | OD
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Telephone | 601-636-3937
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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 | 804
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License Number State | MS
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