| Organization Name: | LAKELAND OPTICAL, LLP |
| NPI Number: | 1265581599 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WINDELL LEE LEWIS (MANAGER) |
| Mailing Address: | 3000 Old Canton Rd Suite 100 Jackson |
| State: | MS US |
| Postal Code: | 392164200 |
| Phone Number: | 6019829477 |
| Fax Number: | 6019824401 |
| NPI Enumeration Date: | 01/09/2007 |
| NPI Last Update Date: | 07/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332H00000X |
| License Number: | C08463429 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MS |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Eyewear Supplier (Equipment, not the service) |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |