MEDICARE: JACKSON EYE ASSOCIATES PLLC

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	332B00000X	Durable Medical Equipment & Medical Supplies	34859	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CH0425	OTHER	MS	MEDICARE RR

General Provider Information

NPI Number	:	1881694354
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JACKSON EYE ASSOCIATES PLLC

Provider Business Mailing Address
First Line	:	1190 N STATE ST
Second Line	:	SUITE 101
City	:	JACKSON
State	:	MS
Zip	:	39202-2413
Country	:	US
Telephone Number	:	601-352-0025
Fax Number	:	601-352-0037

Provider Business Practice Location Address
First Line	:	1190 N STATE ST
Second Line	:	SUITE 101
City	:	JACKSON
State	:	MS
Zip	:	39202-2413
Country	:	US
Telephone Number	:	601-352-0025
Fax Number	:	601-352-0037

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	DR. JOHN H MCVEY
Credential	:	MD
Telephone Number	:	601-352-0025

Provider Enumeration Date	:	07/27/2005
Last Update Date	:	04/15/2009

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Directions to “JACKSON EYE ASSOCIATES PLLC ” Practice Location

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