Provider Demographics
NPI:1811664147
Name:FERRELL, LAUREN COLEMAN (OD)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:COLEMAN
Last Name:FERRELL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 WORSHAM DR
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-8674
Mailing Address - Country:US
Mailing Address - Phone:662-603-3880
Mailing Address - Fax:
Practice Address - Street 1:3201 GAINES RD
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-8422
Practice Address - Country:US
Practice Address - Phone:662-286-8860
Practice Address - Fax:662-286-3079
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1037152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist