Jon Bantugan, OD Valid NPI
Individual provider · Optometrist · Vicksburg, MS
- NPI
- 1346169299
- Type
- Individual (Type 1)
- Primary specialty
- Optometrist
- Specialty group
- Eye and Vision Services Providers
- Taxonomy code
- 152W00000X
- License number
- 1129 (MS)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2026-07-14
- Last updated
- 2026-07-14
Practice location
2011 Highway 61 N
Vicksburg, MS 39183-8227
(601) 630-9199