Provider Demographics
NPI:1942584693
Name:FRIER FAMILY EYE CARE INC
Entity Type:Organization
Organization Name:FRIER FAMILY EYE CARE INC
Other - Org Name:ACUTE VISION EYE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:601-636-3937
Mailing Address - Street 1:PO BOX 4066
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39047-4066
Mailing Address - Country:US
Mailing Address - Phone:601-636-3937
Mailing Address - Fax:
Practice Address - Street 1:2152 IOWA BLVD
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39180-5572
Practice Address - Country:US
Practice Address - Phone:601-636-3937
Practice Address - Fax:601-778-0107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-29
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS804152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03678346Medicaid
MS03678346Medicaid