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Organization
COOPER - PANG EYE CLINIC, P.A.
Active
Organization
COOPER - PANG EYE CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR PANG (VICE-PRESIDENT)
(662) 627-5256
Entity
Organization
Contact information
Practice address
561 MEDICAL DRIVE, CLARKSDALE, MS 38614
(662) 627-5256
Mailing address
561 MEDICAL DRIVE, CLARKSDALE, MS 38614
(662) 627-5256
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
NULL
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09014158
—
MS
01
—
CD1827
RAILROAD MEDICARE
—
Enumeration date
10/02/2006
Last updated
02/15/2008
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