Provider Demographics
NPI:1427346733
Name:EATON, LAUREN ROBERTSON (OD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ROBERTSON
Last Name:EATON
Suffix:
Gender:
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:PO BOX 655
Mailing Address - Street 2:
Mailing Address - City:KOSCIUSKO
Mailing Address - State:MS
Mailing Address - Zip Code:39090-0655
Mailing Address - Country:US
Mailing Address - Phone:662-289-9581
Mailing Address - Fax:662-289-9967
Practice Address - Street 1:337 HIGHWAY 12 W
Practice Address - Street 2:
Practice Address - City:KOSCIUSKO
Practice Address - State:MS
Practice Address - Zip Code:39090-3255
Practice Address - Country:US
Practice Address - Phone:662-289-9581
Practice Address - Fax:662-289-9967
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS840152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist