Provider Demographics
NPI:1275645889
Name:BRIGHT, SANDRA LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LYNN
Last Name:BRIGHT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:365 HIGHWAY 51 N
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-2311
Mailing Address - Country:US
Mailing Address - Phone:662-563-9880
Mailing Address - Fax:662-563-9882
Practice Address - Street 1:365 HIGHWAY 51 N
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-2311
Practice Address - Country:US
Practice Address - Phone:662-563-9880
Practice Address - Fax:662-563-9882
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS736152W00000X, 152WP0200X, 152WS0006X, 152WX0102X, 156FC0800X, 156FC0801X, 156FX1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
No156FC0800XEye and Vision Services ProvidersTechnician/TechnologistContact Lens
No156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter
No156FX1100XEye and Vision Services ProvidersTechnician/TechnologistOphthalmic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP00442834OtherRAILROAD MEDICARE PTAN
MS03771729Medicaid
MSP00442834OtherRAILROAD MEDICARE PTAN
MS03771729Medicaid