Provider Demographics
NPI:1154586089
Name:FLEMING, EMILY NAIL (OD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:NAIL
Last Name:FLEMING
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 1:210 BANK ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MS
Mailing Address - Zip Code:39365-2504
Mailing Address - Country:US
Mailing Address - Phone:601-774-9529
Mailing Address - Fax:601-774-8566
Practice Address - Street 1:210 BANK ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MS
Practice Address - Zip Code:39365-2504
Practice Address - Country:US
Practice Address - Phone:601-774-9529
Practice Address - Fax:601-774-8566
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-21
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS795152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00488011Medicaid
MS00488011Medicaid
MS512G700485Medicare PIN