Provider Demographics
NPI:1982788022
Name:MEGAN SUMRALL, OD, PLLC
Entity Type:Organization
Organization Name:MEGAN SUMRALL, OD, PLLC
Other - Org Name:LEXINGTON EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LOTT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:662-834-2982
Mailing Address - Street 1:210 COURT SQ
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MS
Mailing Address - Zip Code:39095-3628
Mailing Address - Country:US
Mailing Address - Phone:662-834-2982
Mailing Address - Fax:
Practice Address - Street 1:210 COURT SQ
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MS
Practice Address - Zip Code:39095-3628
Practice Address - Country:US
Practice Address - Phone:662-834-2982
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS760152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS427610516OtherBLUE CROSS BLUE SHIELD
MS427610516OtherBLUE CROSS BLUE SHIELD