Provider Demographics
NPI:1578713137
Name:SETZER VISION LLC
Entity Type:Organization
Organization Name:SETZER VISION LLC
Other - Org Name:SETZER VISION CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SETZER
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:601-991-1116
Mailing Address - Street 1:127 KATHERINE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7909
Mailing Address - Country:US
Mailing Address - Phone:901-864-7075
Mailing Address - Fax:
Practice Address - Street 1:815 S WHEATLEY ST
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-5002
Practice Address - Country:US
Practice Address - Phone:601-991-1116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2016-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS784152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty