Provider Demographics
NPI:1679686984
Name:NATIONS, LOY WILLARD JR (OD)
Entity Type:Individual
Prefix:DR
First Name:LOY
Middle Name:WILLARD
Last Name:NATIONS
Suffix:JR
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 1:1053 RIVER OAKS DR
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-9595
Mailing Address - Country:US
Mailing Address - Phone:601-969-1430
Mailing Address - Fax:601-709-2117
Practice Address - Street 1:1053 RIVER OAKS DR
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9595
Practice Address - Country:US
Practice Address - Phone:601-969-1430
Practice Address - Fax:601-709-2117
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS464152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00087825Medicaid
MS00087825Medicaid
MS00087825Medicaid