Provider Demographics
NPI:1275271322
Name:MCARTHUR, JOSEPH BRENNAN (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BRENNAN
Last Name:MCARTHUR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 E LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-2209
Mailing Address - Country:US
Mailing Address - Phone:601-502-5758
Mailing Address - Fax:
Practice Address - Street 1:1621 HIGHWAY 15 N
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-2123
Practice Address - Country:US
Practice Address - Phone:601-518-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MS1052P-Y152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program