MEDICARE: DR. JOHN PHILIP NAIL JR. O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	852	MS

General Provider Information

NPI Number	:	1174878052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN PHILIP NAIL JR. O.D.

Provider Business Mailing Address
First Line	:	PO BOX 9099
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-0038
Country	:	US
Telephone Number	:	662-328-5225
Fax Number	:	662-327-5950

Provider Business Practice Location Address
First Line	:	1823 5TH ST N
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39705-2203
Country	:	US
Telephone Number	:	662-231-9293
Fax Number	:	662-327-5950

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2012
Last Update Date	:	07/08/2019

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