Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Jay Fuller, OD

Individual provider Optometrist · NPI 1053667758

Dr. Jay Fuller, OD is an Optometry in Gulfport, Mississippi. Graduated from Southern College of Optometry in 2012, 14 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
14
Trained at
Southern College of Optometry
Licensed in
MS
In the registry since
2012
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

2170 E Pass Rd Ste A
Gulfport, MS 39507-3864
Phone: (228) 262-0266
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 851 (MS)

Record details

NPI number1053667758
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorYes
NPI enumeratedJuly 31, 2012
Last updated in NPPESDecember 30, 2022
Certification dateDecember 30, 2022
Mailing address2170 E Pass Rd Ste A, Gulfport, MS 39507-3864

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolSOUTHERN COLLEGE OF OPTOMETRY
Graduated 2012 (14 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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